Healthcare Provider Details

I. General information

NPI: 1770354300
Provider Name (Legal Business Name): LIDBETH K SOLORZANO RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

13354 ALDERGROVE ST
SYLMAR CA
91342-1828
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-4439
  • Fax:
Mailing address:
  • Phone: 310-268-4439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number133869
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: