Provider Demographics
NPI:1568500551
Name:SOLTYS, SCOTT GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:GERARD
Last Name:SOLTYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:875 BLAKE WILBUR DR
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5847
Mailing Address - Country:US
Mailing Address - Phone:650-724-1569
Mailing Address - Fax:650-725-8231
Practice Address - Street 1:875 BLAKE WILBUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5847
Practice Address - Country:US
Practice Address - Phone:650-724-1569
Practice Address - Fax:650-725-8231
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA784172085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI34045Medicare UPIN