Active NPI
Sandra So
- Specialist
- Chino, CA
National Provider Identifier
1184723306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A50856
- Practice address
- 12584 Central Ave
Chino, CA 91710-3507 - Phone
- (909) 287-1800
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A50856 | CA | Primary |
Addresses
Primary practice location
12584 Central Ave
Chino, CA 91710-3507
Mailing address
12584 Central Ave
Chino, CA 91710-3507
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A508560 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A50856 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chino Pediatrics Medical Clinic, Inc. | Past | Accepting new patients | |
| Ahmc Whittier Hospital Medical Center LP | Past | Accepting new patients | |
| Pomona Valley Hospital Medical Center | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Chino, CA
- NPI 1881266344
-
- Medicare Defined Swing Bed Hospital Unit
- Whittier, CA
- NPI 1497855605
-
- General Acute Care Hospital
- Pomona, CA
- NPI 1518067586
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184723306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12584 CENTRAL AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "917103507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12584 CENTRAL AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "917103507",
"telephone_number": "909-287-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SO",
"first_name": "SANDRA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A50856",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A508560",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.