Provider Demographics
NPI:1376206672
Name:SOHAIL, SINDY (PA-C)
Entity Type:Individual
Prefix:
First Name:SINDY
Middle Name:
Last Name:SOHAIL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SINDY
Other - Middle Name:
Other - Last Name:RESTREPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:11755 MALAGA DR UNIT 1237
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8132
Mailing Address - Country:US
Mailing Address - Phone:954-629-1901
Mailing Address - Fax:
Practice Address - Street 1:11755 MALAGA DR UNIT 1237
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8132
Practice Address - Country:US
Practice Address - Phone:954-629-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA60219363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant