Provider Demographics
NPI:1013989136
Name:SOLOMON, DANIEL JORDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JORDAN
Last Name:SOLOMON
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 1:18 BON AIR RD
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1123
Mailing Address - Country:US
Mailing Address - Phone:415-927-5300
Mailing Address - Fax:415-927-6860
Practice Address - Street 1:18 BON AIR RD
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1123
Practice Address - Country:US
Practice Address - Phone:415-927-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54759207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine