Healthcare Provider Details

I. General information

NPI: 1770348443
Provider Name (Legal Business Name): ANDREW JEFFREY SOLOMON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 EAST HART ST
YUMA AZ
85369
US

IV. Provider business mailing address

34800 BOB WILSON DR
SAN DIEGO CA
92134-5000
US

V. Phone/Fax

Practice location:
  • Phone: 928-269-2700
  • Fax:
Mailing address:
  • Phone: 623-308-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0102209482
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: