Healthcare Provider Details

I. General information

NPI: 1538431598
Provider Name (Legal Business Name): WILLIAM N SOKOL JR M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NEWPORT CENTER DR #406
NEWPORT BEACH CA
92660
US

IV. Provider business mailing address

400 NEWPORT CENTER DR #406
NEWPORT BEACH CA
92660
US

V. Phone/Fax

Practice location:
  • Phone: 949-645-3374
  • Fax: 949-645-2410
Mailing address:
  • Phone: 949-645-3374
  • Fax: 949-645-2410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberC31823
License Number StateCA

VIII. Authorized Official

Name: WILLIAM N SOKOL JR.
Title or Position: OWNER
Credential: MD
Phone: 949-645-3374