Healthcare Provider Details

I. General information

NPI: 1104160449
Provider Name (Legal Business Name): SONJA S DAIS OWENS D.V.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E SAN BERNARDINO RD
COVINA CA
91723-1623
US

IV. Provider business mailing address

222 E SAN BERNARDINO RD
COVINA CA
91723-1623
US

V. Phone/Fax

Practice location:
  • Phone: 626-331-5374
  • Fax: 626-967-8512
Mailing address:
  • Phone: 626-331-5374
  • Fax: 626-967-8512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number13245
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: