| Organization Name: | AMY SOLOMON MD A PROFESSIONAL MEDICAL CORPORATION |
| NPI Number: | 1427202829 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMY BERKE SOLOMON (LEAD PHYSICIAN / OWNER) |
| Mailing Address: | 231 Main St #a Ben Lomond |
| State: | CA US |
| Postal Code: | 950059394 |
| Phone Number: | 8313361300 |
| Fax Number: | 8313361301 |
| NPI Enumeration Date: | 11/12/2008 |
| NPI Last Update Date: | 01/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G80644 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |