Basic Information
| Provider Information | |||||||||
| NPI: | 1003881665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOORI | ||||||||
| FirstName: | NILANTHI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 EAST CENTER AVE. | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932916331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597374700 | ||||||||
| FaxNumber: | 5597374782 | ||||||||
| Practice Location | |||||||||
| Address1: | 007 CHOOSGAI DRIVE | ||||||||
| Address2: | |||||||||
| City: | TOHATCHI | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5057338400 | ||||||||
| FaxNumber: | 5057221310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 11/28/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD00044845 | WA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A93967 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.