Healthcare Provider Details

I. General information

NPI: 1992660526
Provider Name (Legal Business Name): BIJAN SAMY SALIB SOLIMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23104 SAMUEL ST APT 212
TORRANCE CA
90505-3840
US

IV. Provider business mailing address

23104 SAMUEL ST APT 212
TORRANCE CA
90505-3840
US

V. Phone/Fax

Practice location:
  • Phone: 310-796-6067
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number111650
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: