Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 29480 | CA |
NPI | 1043372154 |
---|---|
Provider Name | Dr. Nile Sorenson |
First Address | Yorba Linda, CA 92887-2508 |
Second Address | Yorba Linda, CA 92887-2508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |