Healthcare Provider Details

I. General information

NPI: 1225941362
Provider Name (Legal Business Name): SONOBLOOM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 N 400 E STE D
LOGAN UT
84341-1756
US

IV. Provider business mailing address

664 S LAKESIDE DR
FRANKLIN ID
83237-5302
US

V. Phone/Fax

Practice location:
  • Phone: 435-938-3024
  • Fax: 435-241-7345
Mailing address:
  • Phone: 909-276-0484
  • Fax: 435-241-7345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: LENNA MARIE PINEDO
Title or Position: OWNER/SONOGRAPHER
Credential: RDMS, RDCS
Phone: 909-276-0484