MEDICARE: EDMUNDO SORIANO LVN

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	164X00000X	Licensed Vocational Nurse	VN163730	CA

General Provider Information

NPI Number	:	1518244557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDMUNDO SORIANO LVN

Provider Business Mailing Address
First Line	:	5779 W. BLUFF AVE.
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5779 W. BLUFF AVE.
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722
Country	:	US
Telephone Number	:	559-277-0214
Fax Number	:

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

Provider Enumeration Date	:	11/04/2011
Last Update Date	:	03/15/2026

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