Provider Demographics
NPI:1790931590
Name:SIROUNIAN, SONA (OD)
Entity Type:Individual
Prefix:DR
First Name:SONA
Middle Name:
Last Name:SIROUNIAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 19TH ST APT 28
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-4623
Mailing Address - Country:US
Mailing Address - Phone:323-919-9170
Mailing Address - Fax:
Practice Address - Street 1:8250 DAY CREEK BLVD
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-8550
Practice Address - Country:US
Practice Address - Phone:909-646-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT13549152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist