Provider Demographics
NPI:1508836727
Name:SONI, BIKRAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:BIKRAM
Middle Name:J
Last Name:SONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-3512
Mailing Address - Country:US
Mailing Address - Phone:559-896-0400
Mailing Address - Fax:559-896-0404
Practice Address - Street 1:2001 HIGH ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3512
Practice Address - Country:US
Practice Address - Phone:559-896-0400
Practice Address - Fax:559-896-0404
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74940207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA74940OtherCA LIC
CAG88356Medicare UPIN
CA124608Medicare PIN