Provider Demographics
NPI:1609617091
Name:SOLOMONS MIND & EYES
Entity type:Organization
Organization Name:SOLOMONS MIND & EYES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:GAYE
Authorized Official - Last Name:CLAIBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DRIVER
Authorized Official - Phone:318-482-4521
Mailing Address - Street 1:2185 E CENTURY BLVD APT 105
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-4019
Mailing Address - Country:US
Mailing Address - Phone:318-482-4521
Mailing Address - Fax:
Practice Address - Street 1:2185 E CENTURY BLVD APT 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-4019
Practice Address - Country:US
Practice Address - Phone:318-482-4521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare