Provider Demographics
NPI:1558633099
Name:SORIA, ELSA
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:
Last Name:SORIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 ZOE AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-6994
Mailing Address - Country:US
Mailing Address - Phone:323-826-6300
Mailing Address - Fax:323-277-7862
Practice Address - Street 1:2677 ZOE AVE STE 301
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6994
Practice Address - Country:US
Practice Address - Phone:323-826-6300
Practice Address - Fax:323-277-7862
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner