Healthcare Provider Details

I. General information

NPI: 1093036543
Provider Name (Legal Business Name): WELIM SONYE AZINGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WELIM SONYE AZINGE M.D

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 04/30/2022
Certification Date: 04/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 N IMPERIAL AVE STE D
EL CENTRO CA
92243-1607
US

IV. Provider business mailing address

9830 N MAGNOLIA AVE STE 200
SANTEE CA
92071-1901
US

V. Phone/Fax

Practice location:
  • Phone: 760-693-5372
  • Fax: 760-693-5375
Mailing address:
  • Phone: 760-693-5372
  • Fax: 760-693-5375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA126925
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: