Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 20A15110 | CA |
NPI | 1235517665 |
---|---|
Provider Name | Dr. Ilana Solomon |
First Address | Reseda, CA 91335-3700 |
Second Address | Reseda, CA 91335-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2015 |
Last Update Date | 31/08/2021 |