Provider Demographics
NPI:1003541947
Name:SOLECKI, PAUL (RT)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SOLECKI
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21649 MASTERSON CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-1663
Mailing Address - Country:US
Mailing Address - Phone:425-418-8943
Mailing Address - Fax:
Practice Address - Street 1:21649 MASTERSON CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-1663
Practice Address - Country:US
Practice Address - Phone:425-418-8943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
309869247100000X, 2471C1101X
CARHT00113923247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C1101XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiovascular-Interventional Technology
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist