Provider Demographics
NPI:1861681447
Name:ADVANI, SONAL JAIN (MD)
Entity Type:Individual
Prefix:
First Name:SONAL
Middle Name:JAIN
Last Name:ADVANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONAL
Other - Middle Name:
Other - Last Name:JAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:925-875-3750
Mailing Address - Fax:
Practice Address - Street 1:915 SAN RAMON VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4062
Practice Address - Country:US
Practice Address - Phone:925-875-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98866207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine