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General NPI Number Information
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NPI Number | 1780659953
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Entity Type | Individual
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Provider Name | SONIA B. RICHARDS M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 16542 VENTURA BLVD STE 122
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City | ENCINO
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State | CA
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Zip | 91436-5034
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Country | US
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Telephone | 818-701-9211
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Fax | 818-701-6327
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Provider Business Mailing Address
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Address Line | 6038 TAMPA AVE # 315
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City | TARZANA
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State | CA
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Zip | 91356-1135
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Country | US
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Telephone | 818-633-4133
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | G46432
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License Number State | CA
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