Healthcare Provider Details

I. General information

NPI: 1568994861
Provider Name (Legal Business Name): PETER SORIAL SOLIMAN M.D., MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25815 BARTON RD STE 102
LOMA LINDA CA
92354-3894
US

IV. Provider business mailing address

25815 BARTON RD STE 102
LOMA LINDA CA
92354-3894
US

V. Phone/Fax

Practice location:
  • Phone: 909-478-1000
  • Fax:
Mailing address:
  • Phone: 909-522-6443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA157756
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA157556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: