Provider Demographics
NPI:1356482541
Name:SOLIS, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SOLIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 SAN DIEGO AVE
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-2168
Mailing Address - Country:US
Mailing Address - Phone:619-297-1519
Mailing Address - Fax:619-297-0705
Practice Address - Street 1:1851 SAN DIEGO AVE
Practice Address - Street 2:SUITE 100B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2168
Practice Address - Country:US
Practice Address - Phone:619-297-1519
Practice Address - Fax:619-297-0705
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU51377Medicare UPIN
CAWDC21516AMedicare ID - Type Unspecified