Provider Demographics
NPI:1679626428
Name:SONIA Y TOVAR PROFESIONAL CORPORATION NURSING
Entity type:Organization
Organization Name:SONIA Y TOVAR PROFESIONAL CORPORATION NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:909-623-7799
Mailing Address - Street 1:1019 E HOLT AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-0000
Mailing Address - Country:US
Mailing Address - Phone:909-623-7799
Mailing Address - Fax:
Practice Address - Street 1:1019 E HOLT AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-0000
Practice Address - Country:US
Practice Address - Phone:909-623-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP12356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP0123560Medicaid