Individual
TERESA TABORA SORIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, #450, LOS ANGELES, CA 90095
(310) 825-6911
(310) 794-7005
Mailing address
200 MEDICAL PLAZA, 465, LOS ANGELES, CA 90095
(310) 825-6911
(310) 794-7005
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A62639
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G629740
—
CA
Enumeration date
10/17/2006
Last updated
12/26/2012
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