Basic Information
Provider Information
NPI: 1891972220
EntityType: 2
ReplacementNPI:  
OrganizationName: ROGER SOHN INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 26730 CROWN VALLEY PARKWAY
Address2: SUITE 200
City: MISSION VIEJO
State: CA
PostalCode: 92691
CountryCode: US
TelephoneNumber: 9493642154
FaxNumber: 9493642110
Practice Location
Address1: 26730 CROWN VALLEY PARKWAY
Address2: SUITE 200
City: MISSION VIEJO
State: CA
PostalCode: 926916364
CountryCode: US
TelephoneNumber: 9493642154
FaxNumber: 9493642110
Other Information
ProviderEnumerationDate: 01/28/2008
LastUpdateDate: 04/01/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SOHN
AuthorizedOfficialFirstName: ROGER
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3104133994
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XA83858CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


Home