Provider Demographics
NPI:1235147380
Name:SONI, RAJESH N (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:N
Last Name:SONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11033 N PINTO DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-5328
Mailing Address - Country:US
Mailing Address - Phone:480-385-9896
Mailing Address - Fax:480-248-9544
Practice Address - Street 1:11033 N PINTO DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-5328
Practice Address - Country:US
Practice Address - Phone:480-385-9896
Practice Address - Fax:480-248-9544
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41442207Q00000X
CAA65918207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A659180Medicaid
AZ404291Medicaid
H04785Medicare UPIN
AZ404291Medicaid
AZZ149109Medicare PIN