Provider Demographics
NPI:1235831074
Name:SOLOMON, SPENCER HOWARD ALBERT
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:HOWARD ALBERT
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:DEATH VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92328-0579
Mailing Address - Country:US
Mailing Address - Phone:760-786-3292
Mailing Address - Fax:
Practice Address - Street 1:579 COW CREEK SERVICE ROAD
Practice Address - Street 2:
Practice Address - City:DEATH VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92328
Practice Address - Country:US
Practice Address - Phone:760-786-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic