Healthcare Provider Details

I. General information

NPI: 1346459872
Provider Name (Legal Business Name): CECILIA SORIANO-CASACLANG, M.D INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 GRAND AVE SUITE A
CHINO HILLS CA
91709-1478
US

IV. Provider business mailing address

3626 GRAND AVE SUITE A
CHINO HILLS CA
91709-1478
US

V. Phone/Fax

Practice location:
  • Phone: 909-364-0602
  • Fax:
Mailing address:
  • Phone: 909-364-0602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA46035
License Number StateCA

VIII. Authorized Official

Name: MR. RENATO D CASACLANG
Title or Position: VICE PRESIDENT
Credential:
Phone: 909-364-0602