Provider Demographics
NPI:1659381770
Name:HAKIMI, SOLEMON (MD)
Entity Type:Individual
Prefix:
First Name:SOLEMON
Middle Name:
Last Name:HAKIMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20040
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91416-0040
Mailing Address - Country:US
Mailing Address - Phone:818-884-9400
Mailing Address - Fax:818-884-0994
Practice Address - Street 1:2915 SANTA MONICA BLVD
Practice Address - Street 2:STE 1
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-449-0098
Practice Address - Fax:310-453-6229
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45921208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA00459210Medicaid
CAA00459210Medicaid
CAD79151Medicare UPIN