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NPI Code Detail

MEDICARE: MR. FRITZ M SOLIS BA

MEDICARE: MR. FRITZ M SOLIS BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCA

General Provider Information

NPI Number : 1134343742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FRITZ M SOLIS BA
Provider Business Mailing Address
First Line : 74501 42ND AVE
Second Line : APT E-25
City : PALM DESERT
State : CA
Zip : 92260-1997
Country : US
Telephone Number : 760-862-1261
Fax Number :
Provider Business Practice Location Address
First Line : 44199 MONROE ST
Second Line :
City : INDIO
State : CA
Zip : 92201-3094
Country : US
Telephone Number : 760-863-2907
Fax Number : 760-863-2943
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 12/01/2007

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