Healthcare Provider Details
I. General information
NPI: 1467542126
Provider Name (Legal Business Name): SOLANO ORTHOPAEDIC SPINE AND JOINT, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/13/2006
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1090 ADAMS STREET SUITE G
BENICIA CA
94510-2953
US
IV. Provider business mailing address
1090 ADAMS STREET SUITE G
BENICIA CA
94510-2953
US
V. Phone/Fax
- Phone: 707-748-3100
- Fax: 707-745-3100
- Phone: 707-748-3100
- Fax: 707-745-3100
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | G31423 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | G31423 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
DAVID
C.M.
SCHIFF
Title or Position: WNER
Credential: M.D.
Phone: 707-748-3100