Provider Demographics
NPI:1336109172
Name:SOLMER, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:SOLMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 PLACENTIA AVE
Mailing Address - Street 2:STE 208
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3308
Mailing Address - Country:US
Mailing Address - Phone:949-548-0227
Mailing Address - Fax:949-548-0282
Practice Address - Street 1:307 PLACENTIA AVE
Practice Address - Street 2:STE 208
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3308
Practice Address - Country:US
Practice Address - Phone:949-548-0227
Practice Address - Fax:949-548-0282
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26367208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG26370Medicaid
953738470OtherEIN IRS
CAG26367Medicare PIN
A90988Medicare UPIN