Provider Demographics
NPI:1952769416
Name:MANHOOBI, SOHIL (OD)
Entity Type:Individual
Prefix:DR
First Name:SOHIL
Middle Name:
Last Name:MANHOOBI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 INLAND SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-1937
Mailing Address - Country:US
Mailing Address - Phone:909-381-7661
Mailing Address - Fax:
Practice Address - Street 1:330 INLAND SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-1937
Practice Address - Country:US
Practice Address - Phone:909-381-7661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15421152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist