Healthcare Provider Details

I. General information

NPI: 1043114101
Provider Name (Legal Business Name): GILMAR ANDREI SOL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15720 BERNARDO CENTER DR
SAN DIEGO CA
92127-5899
US

IV. Provider business mailing address

16937 HUTCHINS LNDG UNIT 87
SAN DIEGO CA
92127-6855
US

V. Phone/Fax

Practice location:
  • Phone: 858-672-3900
  • Fax:
Mailing address:
  • Phone: 858-335-6077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95468528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: