Provider Demographics
NPI:1811940661
Name:SOLANO DIAGNOSTICS PARTNERS A CALIF LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:SOLANO DIAGNOSTICS PARTNERS A CALIF LIMITED PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELNORA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-646-3288
Mailing Address - Street 1:1101 B GALE WILSON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-3700
Mailing Address - Country:US
Mailing Address - Phone:707-646-4777
Mailing Address - Fax:707-399-2648
Practice Address - Street 1:1101 B GALE WILSON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3700
Practice Address - Country:US
Practice Address - Phone:707-646-4777
Practice Address - Fax:707-399-2648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0046118Medicaid
CADIAA00200Medicaid
CAGR0046116Medicaid
CAGR0046117Medicaid
CAGR0046118Medicaid
CAZZZ29503ZMedicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
CAZZZ29502ZMedicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
CAGR0046117Medicaid