Provider Demographics
NPI:1376694364
Name:SONI, VANDANA (MD)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:
Last Name:SONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9940 TALBERT AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5153
Mailing Address - Country:US
Mailing Address - Phone:949-583-9944
Mailing Address - Fax:949-583-9955
Practice Address - Street 1:9940 TALBERT AVE
Practice Address - Street 2:STE. 101
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5153
Practice Address - Country:US
Practice Address - Phone:949-631-2008
Practice Address - Fax:949-631-2036
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2015-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA37842207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37842Medicare PIN