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General NPI Number Information
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NPI Number | 1609617091
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Entity Type | Organization
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Legal Business Name | SOLOMONS MIND & EYES
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Dates
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Enumeration Date | 06/01/2024
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Last Update Date | 06/01/2024
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Provider Practice Location Address
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Address Line | 2185 E CENTURY BLVD APT 105
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City | LOS ANGELES
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State | CA
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Zip | 90002-4019
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Country | US
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Telephone | 318-482-4521
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Fax |
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Provider Business Mailing Address
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Address Line | 2185 E CENTURY BLVD APT 105
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City | LOS ANGELES
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State | CA
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Zip | 90002-4019
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Country | US
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Telephone | 318-482-4521
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA GAYE CLAIBORNE
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Credential | DRIVER
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Telephone | 318-482-4521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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