Provider Demographics
NPI:1194697540
Name:SOLOMON AESTHETIC PODIATRY PC
Entity type:Organization
Organization Name:SOLOMON AESTHETIC PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-583-0055
Mailing Address - Street 1:12826 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3065
Mailing Address - Country:US
Mailing Address - Phone:818-583-0055
Mailing Address - Fax:818-583-0054
Practice Address - Street 1:12826 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3065
Practice Address - Country:US
Practice Address - Phone:818-583-0055
Practice Address - Fax:818-583-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty