Most Relevant Information
Provider Data
| NPI Number: | 1003440579 |
| Provider Name: | SOPHIE SAN |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/24/2020 |
| Last Updated: | 02/24/2020 |
Provider Practice Location
2291 W MARCH LN
STOCKTON
CA
952076652
Practice Location Phone/Fax
| Phone: | 2094239676 |
| Fax: |
Provider Mailing Location
2291 W MARCH LN
STOCKTON
CA
952076652
Provider Mailing Phone/Fax
| Phone: | 2094239676 |
| Fax: |