Provider Demographics
NPI:1043321870
Name:SOLOW, LEE HOWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:HOWARD
Last Name:SOLOW
Suffix:
Gender:M
Credentials:PHD
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Other - First Name:
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Mailing Address - Street 1:702 HELIOTROPE AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2221
Mailing Address - Country:US
Mailing Address - Phone:949-632-5464
Mailing Address - Fax:949-476-7035
Practice Address - Street 1:1101 DOVE ST
Practice Address - Street 2:SUITE 260
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2839
Practice Address - Country:US
Practice Address - Phone:949-955-2575
Practice Address - Fax:949-476-7035
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY7104103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist