Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A54759 | CA |
NPI | 1013989136 |
---|---|
Provider Name | Dr. Daniel Jordan Solomon |
First Address | Larkspur, CA 94939-1123 |
Second Address | Larkspur, CA 94939-1123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 22/10/2018 |