Provider Demographics
NPI:1952331951
Name:SONNO SLEEP CENTER OF NEW MEXICO, P.A.
Entity Type:Organization
Organization Name:SONNO SLEEP CENTER OF NEW MEXICO, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GONZALO
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-533-8499
Mailing Address - Street 1:1004 QUINTA ANTIGUA LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2039
Mailing Address - Country:US
Mailing Address - Phone:915-533-8499
Mailing Address - Fax:915-544-4929
Practice Address - Street 1:2311 N MESA ST STE E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3575
Practice Address - Country:US
Practice Address - Phone:915-533-8499
Practice Address - Fax:915-544-4929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2005-0728174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMPENDINGMedicaid
NMPENDINGMedicare ID - Type Unspecified
NMPENDINGMedicaid