Provider Demographics
NPI:1962498006
Name:SOLINAS, JEFFREY A (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:SOLINAS
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 1:1150 MAIN ST
Mailing Address - Street 2:STE 3
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3747
Mailing Address - Country:US
Mailing Address - Phone:831-728-0551
Mailing Address - Fax:831-728-3279
Practice Address - Street 1:1150 MAIN ST
Practice Address - Street 2:STE 3
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3747
Practice Address - Country:US
Practice Address - Phone:831-728-0551
Practice Address - Fax:831-728-3279
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43136207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G431360Medicaid
CA00G431360Medicaid
CA00G431360Medicare ID - Type Unspecified