Provider Demographics
NPI:1184915225
Name:SONNENBERG, PATRICK MICHAEL (LAC)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:SONNENBERG
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:9955 SCRIPPS WESTVIEW WAY
Mailing Address - Street 2:UNIT 6
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2438
Mailing Address - Country:US
Mailing Address - Phone:619-321-7282
Mailing Address - Fax:858-673-4499
Practice Address - Street 1:15611 POMERADO RD
Practice Address - Street 2:SUITE 100 SOUTH
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2437
Practice Address - Country:US
Practice Address - Phone:619-321-7282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-24
Last Update Date:2011-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA14326171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist