Provider Demographics
NPI:1922723618
Name:SORIANO BONNELL, CONCEPCION ALBAY
Entity Type:Individual
Prefix:MS
First Name:CONCEPCION
Middle Name:ALBAY
Last Name:SORIANO BONNELL
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 1:2411 CHATWIN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2026
Mailing Address - Country:US
Mailing Address - Phone:310-756-3299
Mailing Address - Fax:
Practice Address - Street 1:2411 CHATWIN AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2026
Practice Address - Country:US
Practice Address - Phone:310-756-3299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily