=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104937572
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J. S. SONI, M.D., F.A.C.C. A PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 10/30/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2161 COLORADO AVE SUITE D
-----------------------------------------------------
City | TURLOCK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95382-2011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-634-6555
-----------------------------------------------------
Fax | 209-634-2373
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2161 COLORADO AVE SUITE D
-----------------------------------------------------
City | TURLOCK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95382-2011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-634-6555
-----------------------------------------------------
Fax | 209-634-2373
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. JOGINDER S SONI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 209-634-6555
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | C42276
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------