MEDICARE: MR. RICHARD ALEXANDER SORIANO

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	225100000X	Physical Therapist	PT24465	CA

General Provider Information

NPI Number	:	1528276359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD ALEXANDER SORIANO

Provider Business Mailing Address
First Line	:	3640 26TH ST
Second Line	:	#5
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-4383
Country	:	US
Telephone Number	:	415-307-0595
Fax Number	:	866-826-1821

Provider Business Practice Location Address
First Line	:	290 DIVISION ST
Second Line	:	200
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-4882
Country	:	US
Telephone Number	:	415-863-4922
Fax Number	:

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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