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NPI Code Detail

MEDICARE: MR. MARK I SOLL M.D

MEDICARE: MR. MARK I SOLL M.D
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianG62503CA
2207RP1001XPulmonary Disease PhysicianG62503CA
3207R00000XInternal Medicine PhysicianG62503CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1290012006OTHERCARAILROAD MEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750367587
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK I SOLL M.D
Provider Business Mailing Address
First Line : 1400 E CHURCH ST
Second Line : MEDICAL STAFF OFFICE
City : SANTA MARIA
State : CA
Zip : 93454-5906
Country : US
Telephone Number : 805-739-3114
Fax Number : 805-739-3502
Provider Business Practice Location Address
First Line : 1304 ELLA ST STE A
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4165
Country : US
Telephone Number : 805-549-9555
Fax Number : 805-549-0444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 11/08/2023

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Directions to “ MR. MARK I SOLL M.D” Practice Location

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