MEDICARE: DR. SONYA KIRAN SETHI M.D.

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	208000000X	Pediatrics Physician	A74996	CA

General Provider Information

NPI Number	:	1316081904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONYA KIRAN SETHI M.D.

Provider Business Mailing Address
First Line	:	11633 SAN VICENTE BLVD STE 206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-6513
Country	:	US
Telephone Number	:	310-826-5513
Fax Number	:	310-820-1606

Provider Business Practice Location Address
First Line	:	11633 SAN VICENTE BLVD STE 312
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-6514
Country	:	US
Telephone Number	:	102-078-2003
Fax Number	:	310-207-4174

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	05/30/2019

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