Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 29795 | AZ |
N | 207R00000X | Internist | 29795 | AZ |
N | 111NI0900X | Internist | 29795 | AZ |
NPI | 1225132608 |
---|---|
Provider Name | Dr. Sona S Giknavorian |
First Address | Phoenix, AZ 85016-7862 |
Second Address | Phoenix, AZ 85016-7862 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 21/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
899320 | (05) | AZ |