Provider Demographics
NPI:1447093794
Name:SORIA TRUST
Entity type:Organization
Organization Name:SORIA TRUST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:FELIPE
Authorized Official - Last Name:SORIA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:313-505-9692
Mailing Address - Street 1:415 N EL MOLINO AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1417
Mailing Address - Country:US
Mailing Address - Phone:313-505-9692
Mailing Address - Fax:
Practice Address - Street 1:400 W 30TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-3320
Practice Address - Country:US
Practice Address - Phone:213-284-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty