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General NPI Number Information
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NPI Number | 1417124983
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Entity Type | Organization
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Legal Business Name | SOLIS INC.
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 555 N STATE COLLEGE BLVD STE 208
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City | ANAHEIM
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State | CA
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Zip | 92806-2900
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Country | US
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Telephone | 714-776-3335
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Fax | 714-400-0127
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Provider Business Mailing Address
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Address Line | 555 N STATE COLLEGE BLVD STE 208
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City | ANAHEIM
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State | CA
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Zip | 92806-2900
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Country | US
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Telephone | 714-776-3335
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Fax | 714-400-0127
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAY FAVELA
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Credential | A.A./ B.A
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Telephone | 714-776-3335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | D7045
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License Number State | CA
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