Healthcare Provider Details

I. General information

NPI: 1033525316
Provider Name (Legal Business Name): DR. SONIA SANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 WILSHIRE BLVD
LOS ANGELES CA
90017-1901
US

IV. Provider business mailing address

1111 SW 1ST AVE APT 1822N
MIAMI FL
33130-5405
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-2121
  • Fax:
Mailing address:
  • Phone: 310-403-0070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberUO4242
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS14016
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A16299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: