Provider Demographics
NPI:1992840664
Name:SOLTYNSKI, GRACE (DAOM)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:SOLTYNSKI
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29151 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1601
Mailing Address - Country:US
Mailing Address - Phone:949-285-1914
Mailing Address - Fax:949-481-1990
Practice Address - Street 1:33971 SELVA RD STE 110
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3788
Practice Address - Country:US
Practice Address - Phone:949-240-7773
Practice Address - Fax:949-481-1990
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8831171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist