MEDICARE: DR. STEPHEN SOLDO MD

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
1	207P00000X	Emergency Medicine Physician	G43337	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	00G433370	OTHER	BS OF CA
2	G43337	OTHER	BC OF CA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780620708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN SOLDO MD

Provider Business Mailing Address
First Line	:	PO BOX 28951
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-8951
Country	:	US
Telephone Number	:	888-398-1370
Fax Number	:

Provider Business Practice Location Address
First Line	:	4770 W HERNDON AVE
Second Line	:	SUITE 111
City	:	FRESNO
State	:	CA
Zip	:	93722-8401
Country	:	US
Telephone Number	:	559-450-2273
Fax Number	:	559-450-4555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	12/12/2016

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Directions to “ DR. STEPHEN SOLDO MD” Practice Location

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