Provider Demographics
NPI:1669610689
Name:SONI, SNEHAL (PT)
Entity type:Individual
Prefix:
First Name:SNEHAL
Middle Name:
Last Name:SONI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6275 MULAN ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-0793
Mailing Address - Country:US
Mailing Address - Phone:714-423-6199
Mailing Address - Fax:714-423-6199
Practice Address - Street 1:6275 MULAN ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-0793
Practice Address - Country:US
Practice Address - Phone:714-423-6199
Practice Address - Fax:714-423-6199
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT27827OtherCALIFORNIA PT LICENSE