Healthcare Provider Details

I. General information

NPI: 1982778395
Provider Name (Legal Business Name): RONALD SOKOLSKY L. AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10382 RIVA LARGO AVE
LAS VEGAS NV
89135-6173
US

IV. Provider business mailing address

10382 RIVA LARGO AVE
LAS VEGAS NV
89135-3508
US

V. Phone/Fax

Practice location:
  • Phone: 310-902-0574
  • Fax:
Mailing address:
  • Phone: 310-902-0574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU-619
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: