Provider Demographics
NPI:1609424498
Name:SONOTEC ADVANCED IMAGING INC
Entity Type:Organization
Organization Name:SONOTEC ADVANCED IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-625-9222
Mailing Address - Street 1:72650 FRED WARING DR STE 107
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-5007
Mailing Address - Country:US
Mailing Address - Phone:760-404-0775
Mailing Address - Fax:760-565-7191
Practice Address - Street 1:72650 FRED WARING DR STE 107
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5007
Practice Address - Country:US
Practice Address - Phone:760-404-0775
Practice Address - Fax:760-565-7191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology