Provider Demographics
NPI:1801831730
Name:SOLEIMANY, DARIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIUS
Middle Name:
Last Name:SOLEIMANY
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 1:241 TRAVIS DR
Mailing Address - Street 2:
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93402-4315
Mailing Address - Country:US
Mailing Address - Phone:805-801-8685
Mailing Address - Fax:805-439-1094
Practice Address - Street 1:1551 BISHOP ST
Practice Address - Street 2:SUITE 450
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4635
Practice Address - Country:US
Practice Address - Phone:805-439-1094
Practice Address - Fax:805-439-1094
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35246204D00000X, 207T00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA88352OtherUPIN
19409100OtherUS DEPT OF LABOR
130000422OtherRAILROAD MEDICARE
CA00A352460Medicaid
CA00A352460Medicaid
130000422OtherRAILROAD MEDICARE