Provider Demographics
NPI:1205871399
Name:VIRGILIO J. SORIANO, M.D., INC.
Entity type:Organization
Organization Name:VIRGILIO J. SORIANO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGILIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-810-1522
Mailing Address - Street 1:1559 E AMAR RD
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1679
Mailing Address - Country:US
Mailing Address - Phone:626-810-1522
Mailing Address - Fax:626-810-2793
Practice Address - Street 1:1559 E AMAR RD
Practice Address - Street 2:SUITE F
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1679
Practice Address - Country:US
Practice Address - Phone:626-810-1522
Practice Address - Fax:626-810-2793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A394380Medicaid
CAA85287Medicare UPIN
CAA39438Medicare ID - Type Unspecified