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General NPI Number Information
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NPI Number | 1720109614
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Entity Type | Individual
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Provider Name | ERIK PATRICK SORENSON PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3650 SOUTH ST STE 306
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City | LAKEWOOD
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State | CA
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Zip | 90712-1516
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Country | US
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Telephone | 562-633-6353
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Fax |
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Provider Business Mailing Address
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Address Line | 1253 VALPARAISO DR E
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City | PLACENTIA
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State | CA
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Zip | 92870-3930
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Country | US
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Telephone | 714-986-9915
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Fax | 562-633-4996
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA16044
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License Number State | CA
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