Healthcare Provider Details

I. General information

NPI: 1003750464
Provider Name (Legal Business Name): SONO ULTRASOUND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E DORAN ST APT 109
GLENDALE CA
91206-5321
US

IV. Provider business mailing address

505 E DORAN ST APT 109
GLENDALE CA
91206-5321
US

V. Phone/Fax

Practice location:
  • Phone: 818-747-7080
  • Fax:
Mailing address:
  • Phone: 818-747-7080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DIANA DAVIDYAN
Title or Position: OWNER, CEO
Credential:
Phone: 818-747-7080