Healthcare Provider Details

I. General information

NPI: 1003903519
Provider Name (Legal Business Name): WILLIAM BERNARD SOLOMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CASTRO STREET SUITE 232
SAN FRANCISCO CA
94114-1027
US

IV. Provider business mailing address

45 CASTRO STREET SUITE 232
SAN FRANCISCO CA
94114-1027
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-6810
  • Fax: 415-565-6844
Mailing address:
  • Phone: 415-565-6810
  • Fax: 415-565-6844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG26798
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: