Healthcare Provider Details

I. General information

NPI: 1205342920
Provider Name (Legal Business Name): SOLANO DERMATOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 05/10/2023
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 2ND ST STE 220
NAPA CA
94559-2455
US

IV. Provider business mailing address

2290 SACRAMENTO ST
VALLEJO CA
94590-2929
US

V. Phone/Fax

Practice location:
  • Phone: 707-252-2931
  • Fax:
Mailing address:
  • Phone: 707-643-5785
  • Fax: 707-643-8190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN KEVIN GEISSE
Title or Position: OWNER
Credential: MD
Phone: 707-556-5991