Healthcare Provider Details
I. General information
NPI: 1265635445
Provider Name (Legal Business Name): SONNY GARCHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2007
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6501 COYLE AVE
CARMICHAEL CA
95608-0306
US
IV. Provider business mailing address
6720 BERTNER AVE
HOUSTON TX
77030-2604
US
V. Phone/Fax
- Phone: 916-537-5000
- Fax: 916-851-2884
- Phone: 832-355-2666
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 036-114300 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | A105000 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 036-114300 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | S3169 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: