Provider Demographics
NPI:1467542126
Name:SOLANO ORTHOPAEDIC SPINE AND JOINT, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SOLANO ORTHOPAEDIC SPINE AND JOINT, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CM
Authorized Official - Last Name:SCHIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-748-3100
Mailing Address - Street 1:1090 ADAMS STREET
Mailing Address - Street 2:SUITE G
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-2953
Mailing Address - Country:US
Mailing Address - Phone:707-748-3100
Mailing Address - Fax:707-745-3100
Practice Address - Street 1:1090 ADAMS STREET
Practice Address - Street 2:SUITE G
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-2953
Practice Address - Country:US
Practice Address - Phone:707-748-3100
Practice Address - Fax:707-745-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31423207XS0106X, 207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G314230Medicaid
ZZZ24448ZMedicare ID - Type Unspecified
CA00G314230Medicaid