Provider Demographics
NPI:1073651683
Name:SOLOMON, ORKIDA (OD)
Entity Type:Individual
Prefix:DR
First Name:ORKIDA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 DOMINICAN WAY
Mailing Address - Street 2:SUITE 124
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1528
Mailing Address - Country:US
Mailing Address - Phone:831-476-6943
Mailing Address - Fax:831-476-1473
Practice Address - Street 1:1665 DOMINICAN WAY
Practice Address - Street 2:SUITE 124
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1528
Practice Address - Country:US
Practice Address - Phone:831-476-6943
Practice Address - Fax:831-476-1473
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 12739 T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASDO127390Medicare ID - Type Unspecified