Basic Information
| Provider Information | |||||||||
| NPI: | 1992743421 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SORALUZ | ||||||||
| FirstName: | OSCAR | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 W HORIZON RIDGE PKWY | ||||||||
| Address2: | SUITE #221 | ||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890525013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022339222 | ||||||||
| FaxNumber: | 7026854246 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 W HORIZON RIDGE PKWY | ||||||||
| Address2: | SUITE #221 | ||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890525013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022339222 | ||||||||
| FaxNumber: | 7026854246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2006 | ||||||||
| LastUpdateDate: | 06/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | MD60130489 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | MD60130489 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8902009 | 01 | WA | MEDICARE UNSPECIFIED | OTHER | V113355 | 01 | NV | MEDICARE | OTHER |