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General NPI Number Information
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NPI Number | 1326760190
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Entity Type | Individual
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Provider Name | ABRAM JONATHAN SOLANO
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Gender | Male
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 3530 ATLANTIC AVE STE 203
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City | LONG BEACH
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State | CA
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Zip | 90807-4569
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Country | US
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Telephone | 562-424-7289
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Fax |
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Provider Business Mailing Address
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Address Line | 34415 ROAD 603
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City | MADERA
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State | CA
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Zip | 93638-8081
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 108005
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License Number State | CA
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