Healthcare Provider Details

I. General information

NPI: 1659593267
Provider Name (Legal Business Name): SONICA SAINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 12/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2521 GLENN HENDREN DR STE 402
LIBERTY MO
64068-3388
US

IV. Provider business mailing address

1201 PLEASANT HILL DR
PLATTE CITY MO
64079-9683
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-8445
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5503
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2010021699
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: