Provider Demographics
NPI:1790820199
Name:SOLORZANO, ITALIA ANA (PA-C)
Entity Type:Individual
Prefix:
First Name:ITALIA
Middle Name:ANA
Last Name:SOLORZANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17206 SUMMIT HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3195
Mailing Address - Country:US
Mailing Address - Phone:661-400-9164
Mailing Address - Fax:
Practice Address - Street 1:115 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3606
Practice Address - Country:US
Practice Address - Phone:800-322-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16056363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical