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General NPI Number Information
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NPI Number | 1841126695
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Entity Type | Organization
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Legal Business Name | SONOME DIAGNOSTIC MEDICAL INC.
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Dates
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Enumeration Date | 06/19/2026
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Last Update Date | 06/19/2026
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Provider Practice Location Address
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Address Line | 620 W ROUTE 66 STE 107
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City | GLENDORA
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State | CA
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Zip | 91740-4166
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Country | US
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Telephone | 951-289-7102
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Fax |
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Provider Business Mailing Address
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Address Line | 620 W ROUTE 66 STE 107
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City | GLENDORA
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State | CA
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Zip | 91740-4166
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Country | US
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Telephone | 951-289-7102
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JILLIAN NICOLE CACERES
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Credential | RDMS
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Telephone | 951-289-7102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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