Provider Demographics
NPI:1548945157
Name:SOLOMON, KLAY RYAN (DPT)
Entity type:Individual
Prefix:
First Name:KLAY
Middle Name:RYAN
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E CHAPMAN AVE APT 331
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1993
Mailing Address - Country:US
Mailing Address - Phone:562-418-8193
Mailing Address - Fax:
Practice Address - Street 1:24331 EL TORO RD STE 200
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-3116
Practice Address - Country:US
Practice Address - Phone:949-586-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist