Basic Information
| Provider Information | |||||||||
| NPI: | 1033557301 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SOTO | ||||||||
| FirstName: | ERIC | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3871 VALLE VISTA DR | ||||||||
| Address2: | |||||||||
| City: | CHINO HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917092917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7025414577 | ||||||||
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| Practice Location | |||||||||
| Address1: | 107 NORUMBEGA DR | ||||||||
| Address2: | |||||||||
| City: | MONROVIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027887307 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2013 | ||||||||
| LastUpdateDate: | 01/15/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 1110524 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.