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General NPI Number Information
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NPI Number | 1902691660
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Entity Type | Organization
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Legal Business Name | SOLIS MEDICAL GROUP CA PC
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 341 EVIAN WAY
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City | MT PLEASANT
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State | SC
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Zip | 29464-9261
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Country | US
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Telephone | 833-869-1532
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Fax | 833-869-1553
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Provider Business Mailing Address
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Address Line | 6659 SCHAEFER RD STE 155
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City | DEARBORN
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State | MI
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Zip | 48126-1812
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Country | US
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Telephone | 833-869-1532
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Fax | 833-869-1553
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Authorized Official
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Title or Position | CONSULTANT
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Name | PHOEBE GUTIERREZ
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Credential |
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Telephone | 916-826-4269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084H0002X
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Taxonomy Name | Hospice and Palliative Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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