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General NPI Number Information
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NPI Number | 1780958165
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Entity Type | Organization
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Legal Business Name | GARY A SOLOMON, MD INC
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 2880 ATLANTIC AVE SUITE 210
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City | LONG BEACH
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State | CA
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Zip | 90806-1714
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Country | US
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Telephone | 562-424-7787
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Fax |
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Provider Business Mailing Address
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Address Line | 2880 ATLANTIC AVE SUITE 210
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City | LONG BEACH
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State | CA
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Zip | 90806-1714
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Country | US
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Telephone | 562-424-7787
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY ALAN SOLOMON
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Credential | MD
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Telephone | 562-424-7787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | C042316
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License Number State | CA
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