Provider Demographics
NPI:1710658422
Name:V SOLANO MEDICAL LLC
Entity Type:Organization
Organization Name:V SOLANO MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURROGATE
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:V
Authorized Official - Last Name:SOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-903-7159
Mailing Address - Street 1:996 JOLIET ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-4046
Mailing Address - Country:US
Mailing Address - Phone:303-903-7159
Mailing Address - Fax:
Practice Address - Street 1:4990 KIPLING ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6762
Practice Address - Country:US
Practice Address - Phone:303-456-4882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty