1780249748 NPI number — JULIA SOLOMON, MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780249748 NPI number — JULIA SOLOMON, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JULIA SOLOMON, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780249748
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5110 E BERYL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARADISE VALLEY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85253-1023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-885-8880
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1725 WEST FRYE ROAD
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-885-8880
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2019

Additional Information

Authorized Official

Authorized Official Last Name:
CIAFONE
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
602-885-8880

Provider Taxonomy Codes

  • Taxonomy code: 207VM0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1891763504 . This is a "PHYSICIAN NPI" identifier . This identifiers is of the category "OTHER".




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