Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC12066 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | DC12066 | CA |
NPI | 1376889733 |
---|---|
Provider Name | Dr. Charles L Solomon |
First Address | Santa Paula, CA 93060-9564 |
Second Address | Santa Paula, CA 93060-9564 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2012 |
Last Update Date | 12/12/2012 |