Healthcare Provider Details

I. General information

NPI: 1275636201
Provider Name (Legal Business Name): FILOMENA SORONGON PASCUAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8710 MONROE CT. SUITE # 200
RANCHO CUCAMONGA CA
91730-4884
US

IV. Provider business mailing address

8710 MONROE CT. SUITE # 200
RANCHO CUCAMONGA CA
91730-4884
US

V. Phone/Fax

Practice location:
  • Phone: 909-481-9515
  • Fax: 909-481-9520
Mailing address:
  • Phone: 909-481-9515
  • Fax: 909-481-9520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA42652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: