# SONORA COMMUNITY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SONORA COMMUNITY HOSPITAL
- **Other names:** Sierra Vascular Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598962045
- **Legal business name:** SONORA COMMUNITY HOSPITAL
- **Authorized official:** DAVID L LARSEN (VICE PRESIDENT FOR FINANCE)
- **Authorized official phone:** (209) 536-5011

## Contact information

- **Practice address:** 680 GUZZI LN, STE 104, SONORA, CA 95370-5288
- **Practice address phone:** (209) 536-5090
- **Practice address fax:** (209) 536-3585
- **Mailing address:** 14542 LOLLY LN, SONORA, CA 95370-9226
- **Mailing address phone:** (209) 536-2760
- **Mailing address fax:** (209) 533-7696

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/28/2007
- **Last updated:** 06/04/2009