Healthcare Provider Details

I. General information

NPI: 1871664839
Provider Name (Legal Business Name): BARRY S. SOLOF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2781 W RAMSEY ST
BANNING CA
92220-3700
US

IV. Provider business mailing address

2781 W RAMSEY ST
BANNING CA
92220-3700
US

V. Phone/Fax

Practice location:
  • Phone: 951-875-6713
  • Fax: 951-524-0016
Mailing address:
  • Phone: 951-875-6713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberG29239
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: