Provider Demographics
NPI:1285010736
Name:SONOGRAPHY INTERNATIONAL
Entity Type:Organization
Organization Name:SONOGRAPHY INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOISES
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:BSRT,RDMS,RDCS
Authorized Official - Phone:559-575-5374
Mailing Address - Street 1:3115 N FILBERT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-9106
Mailing Address - Country:US
Mailing Address - Phone:559-575-5374
Mailing Address - Fax:
Practice Address - Street 1:3115 N FILBERT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-9106
Practice Address - Country:US
Practice Address - Phone:559-575-5374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile