Sonic Wave, LLC
Organization Active NPI Physiological Laboratory · Lancaster, CA
NPI 1902659972 · NPPES record last updated Apr 17, 2024
Key facts
- NPI
- 1902659972
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physiological Laboratory 293D00000X
- Legal business name
- SONIC WAVE, LLC
- Practice address
- 626 W Lancaster Blvd Ste 146
Lancaster, CA 93534-3108 - Phone
- (818) 220-1779
- Fax
- (818) 698-8883
- NPI assigned
- Apr 9, 2024
- Organization subpart
- No
Authorized official
- Name
- Maria Susana Espino Gonzales
- Title
- Secretary
- Phone
- (626) 497-2773
Practitioners 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240725001011 | CA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 7416493515 | Practice locations: Lancaster, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physiological Laboratory | 293D00000X | Yes |
Addresses
Primary practice location
626 W Lancaster Blvd Ste 146
Lancaster, CA 93534-3108
Mailing address
626 W Lancaster Blvd Ste 146
Lancaster, CA 93534-3108
Phone (818) 220-1779
Other providers in Lancaster, CA
- Maritza Solis
- Melody Solis
- Adrian Soliven
- Samantha Soltero Haro
- Jina Song
- Sonus-USA, Inc.
- Soo T Park DDS Inc
- Krisana Sookpisal
- Beth Sopkin
- Carole Sopp
All providers in Lancaster, CA · Physiological Laboratory in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.