Provider Demographics
NPI:1770517278
Name:SOLIMAN, JIMMY H (MD)
Entity type:Individual
Prefix:MR
First Name:JIMMY
Middle Name:H
Last Name:SOLIMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1704 W MANCHESTER AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-3034
Mailing Address - Country:US
Mailing Address - Phone:323-778-6215
Mailing Address - Fax:323-778-6312
Practice Address - Street 1:617 W MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-5718
Practice Address - Country:US
Practice Address - Phone:323-778-6215
Practice Address - Fax:323-778-6312
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52791207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A527910Medicaid
CA00A527910Medicaid
CAF71259Medicare UPIN