Provider Demographics
NPI:1326052812
Name:SONI, JATINDER KUMAR (MD)
Entity Type:Individual
Prefix:MR
First Name:JATINDER
Middle Name:KUMAR
Last Name:SONI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6622 N 91ST AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-2569
Mailing Address - Country:US
Mailing Address - Phone:602-759-6883
Mailing Address - Fax:602-224-3315
Practice Address - Street 1:7301 E 2ND ST
Practice Address - Street 2:STE 118
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5600
Practice Address - Country:US
Practice Address - Phone:480-994-1238
Practice Address - Fax:480-994-9649
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2018-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ28435207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ515710Medicaid
H27690Medicare UPIN
Z111338Medicare PIN
AZZ127338Medicare PIN