Provider Demographics
NPI:1558137018
Name:SOLIDARITUS HEALTH CALIFORNIA PC
Entity Type:Organization
Organization Name:SOLIDARITUS HEALTH CALIFORNIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPSA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-256-4116
Mailing Address - Street 1:1025 CONN AVE NW STE 907
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5434
Mailing Address - Country:US
Mailing Address - Phone:202-256-4116
Mailing Address - Fax:
Practice Address - Street 1:6644 LONETREE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4432
Practice Address - Country:US
Practice Address - Phone:202-256-4116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty