Healthcare Provider Details
I. General information
NPI: 1508972787
Provider Name (Legal Business Name): ALAN CONWAY SONNE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/21/2006
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15464 GOLDENWEST ST
WESTMINSTER CA
92683-6149
US
IV. Provider business mailing address
15464 GOLDENWEST ST
WESTMINSTER CA
92683-6149
US
V. Phone/Fax
- Phone: 714-891-9008
- Fax:
- Phone: 714-891-9008
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | G34749 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: