Provider Demographics
NPI:1568994861
Name:SOLIMAN, PETER SORIAL (MD, MPH)
Entity Type:Individual
Prefix:
First Name:PETER SORIAL
Middle Name:
Last Name:SOLIMAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25815 BARTON RD
Mailing Address - Street 2:STE 102
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3894
Mailing Address - Country:US
Mailing Address - Phone:909-522-6443
Mailing Address - Fax:
Practice Address - Street 1:25815 BARTON RD
Practice Address - Street 2:STE 102
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3894
Practice Address - Country:US
Practice Address - Phone:909-478-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA157556208000000X
CAA157756207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty