Provider Demographics
NPI:1013167519
Name:SOLAN, PETER ANTHONY (OTC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:ANTHONY
Last Name:SOLAN
Suffix:
Gender:M
Credentials:OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SHRADER ST
Mailing Address - Street 2:SUITE 650
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1016
Mailing Address - Country:US
Mailing Address - Phone:415-221-0665
Mailing Address - Fax:415-221-0687
Practice Address - Street 1:1 SHRADER ST
Practice Address - Street 2:SUITE 650
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1016
Practice Address - Country:US
Practice Address - Phone:415-221-0665
Practice Address - Fax:415-221-0687
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY92-0487246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist