| Dr Oliver M Solomon Inc | |
|
130 W Route 66 Ste 326 Glendora CA 91740-6252 | |
| (909) 971-9334 | |
| (909) 575-3573 |
| Full Name | Dr Oliver M Solomon Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 130 W Route 66 Ste 326, Glendora, California |
| Authorized Official Name and Position | Oliver M Solomon (PRESIDENT) |
| Authorized Official Contact | 6269638588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Oliver M Solomon Inc Po Box 457 San Dimas CA 91773-0457 Ph: (909) 971-9334 | Dr Oliver M Solomon Inc 130 W Route 66 Ste 326 Glendora CA 91740-6252 Ph: (909) 971-9334 |
| NPI Number | 1609240126 |
|---|---|
| Provider Enumeration Date | 11/20/2015 |
| Last Update Date | 09/23/2024 |
| Medicare PECOS PAC ID | 1951692219 |
|---|---|
| Medicare Enrollment ID | O20160617000331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609240126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 20A7503 (California) | Primary |
| Provider Name | Oliver M Solomon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255403085 PECOS PAC ID: 1052384690 Enrollment ID: I20040812001590 |
| Provider Name | Desirae A Mutuc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215393384 PECOS PAC ID: 2264721695 Enrollment ID: I20160525000435 |
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Devesh N Patel,md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 W Route 66, Suite 302, Glendora, CA 91740 Phone: 626-914-1514 Fax: 626-914-1505 | |
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