Provider Demographics
NPI:1447991203
Name:SOLOMON, JONAH (DNP)
Entity type:Individual
Prefix:DR
First Name:JONAH
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:YONAH
Other - Middle Name:
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12675 LA MIRADA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-2200
Mailing Address - Country:US
Mailing Address - Phone:562-967-2273
Mailing Address - Fax:562-967-2911
Practice Address - Street 1:12675 LA MIRADA BLVD
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-2200
Practice Address - Country:US
Practice Address - Phone:562-967-2273
Practice Address - Fax:562-967-2911
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95155000163W00000X
CA95029075363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse