MEDICARE: TERESA BERNADETTE SOKOL PA C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	G26561	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	14593	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1144213067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA BERNADETTE SOKOL PA C

Provider Business Mailing Address
First Line	:	12291 WASHINGTON BLVD
Second Line	:	SUITE 303
City	:	WHITTIER
State	:	CA
Zip	:	90606-2500
Country	:	US
Telephone Number	:	562-698-6296
Fax Number	:	562-693-6752

Provider Business Practice Location Address
First Line	:	12291 WASHINGTON BLVD
Second Line	:	SUITE 303
City	:	WHITTIER
State	:	CA
Zip	:	90606-2500
Country	:	US
Telephone Number	:	562-698-6296
Fax Number	:	562-693-6752

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	11/10/2017

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