Provider Demographics
NPI:1508835612
Name:SORCI, JONATHAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:J
Last Name:SORCI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:555 E TACHEVAH DR
Mailing Address - Street 2:STE 2E107
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5750
Mailing Address - Country:US
Mailing Address - Phone:760-561-7373
Mailing Address - Fax:760-327-5140
Practice Address - Street 1:555 E TACHEVAH DR
Practice Address - Street 2:STE 2E107
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5750
Practice Address - Country:US
Practice Address - Phone:760-561-7373
Practice Address - Fax:760-327-5140
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA84809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A848090OtherBLUE SHIELD
CA00A848090OtherTRIWEST
CA2734539002OtherCIGNA
CAI13905Medicare UPIN
CA00A848090OtherBLUE SHIELD