Doctor Name: | DR. SONYA MITROVICH |
NPI Number: | 1194928010 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | G87431 |
Business Practice Address: | 26671 Aliso Creek Rd Suite304 Aliso Viejo, CA - 926564809 |
Business Phone Number: | 9498313686 |
Business Fax Number: | |
Mailing Address: | 31 Vista Tramonto, NEWPORT COAST |
State: | CA |
Postal Code: | 926571402 |
Phone Number: | 9493942763 |
Fax Number: | |
NPI Enumeration Date: | 06/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G87431 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |