Healthcare Provider Details

I. General information

NPI: 1235717604
Provider Name (Legal Business Name): SOLOMAN KREIK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22555 ALESSANDRO BLVD STE B
MORENO VALLEY CA
92553-8533
US

IV. Provider business mailing address

3660 PARK SIERRA DR STE 203
RIVERSIDE CA
92505-3071
US

V. Phone/Fax

Practice location:
  • Phone: 951-656-7081
  • Fax: 951-656-1710
Mailing address:
  • Phone: 951-687-3400
  • Fax: 951-687-7630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number20A21537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: