Healthcare Provider Details

I. General information

NPI: 1619199783
Provider Name (Legal Business Name): SONOWAVE IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5608 S SOTO ST SUITE 108
HUNTINGTON PARK CA
90255-2629
US

IV. Provider business mailing address

1833 E 17TH ST SUITE 115
SANTA ANA CA
92705-8629
US

V. Phone/Fax

Practice location:
  • Phone: 714-393-7347
  • Fax:
Mailing address:
  • Phone: 714-393-7347
  • Fax: 714-265-7584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. GILBERT ZAMORA JR.
Title or Position: CEO
Credential:
Phone: 714-393-7347