Basic Information
| Provider Information | |||||||||
| NPI: | 1710107081 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SONI | ||||||||
| FirstName: | DAZY | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | PHYSICAL THERAPIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8231 JADE COAST RD | ||||||||
| Address2: | UNIT #140 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086923299 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5480 MARENGO AVE | ||||||||
| Address2: | |||||||||
| City: | LA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919422408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194630281 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2007 | ||||||||
| LastUpdateDate: | 11/13/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 34085 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 070013024 | IL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.