Provider Demographics
NPI:1891820627
Name:LAKTINEH, SOLOMON (MD)
Entity Type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:
Last Name:LAKTINEH
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 1:780 ATLANTIC AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-4565
Mailing Address - Country:US
Mailing Address - Phone:562-624-1111
Mailing Address - Fax:562-624-1115
Practice Address - Street 1:780 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-4565
Practice Address - Country:US
Practice Address - Phone:562-624-1111
Practice Address - Fax:562-624-1115
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50421208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A504210Medicaid