Healthcare Provider Details

I. General information

NPI: 1629357058
Provider Name (Legal Business Name): JAMES G SOLER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W 1ST ST STE 201
MESA AZ
85201-6653
US

IV. Provider business mailing address

PO BOX 20544
MESA AZ
85277-0544
US

V. Phone/Fax

Practice location:
  • Phone: 480-874-7014
  • Fax: 480-874-7015
Mailing address:
  • Phone: 602-499-6055
  • Fax: 480-393-4477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA0816
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: