MEDICARE: REBECCA SOKOL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	RES.004241	OH
2	122300000X	Dentist	019.033000	IL
3	122300000X	Dentist	DDS107356	CA

General Provider Information

NPI Number	:	1669097523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA SOKOL DDS

Provider Business Mailing Address
First Line	:	8275 CAMINITO MARITIMO
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-2204
Country	:	US
Telephone Number	:	818-530-3431
Fax Number	:

Provider Business Practice Location Address
First Line	:	8915 TOWNE CENTRE DR STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-5606
Country	:	US
Telephone Number	:	858-558-7713
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2020
Last Update Date	:	10/03/2023

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