Provider Demographics
NPI:1861554545
Name:SOLANO, ERNESTO DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:DAVID
Last Name:SOLANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W 17TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-3678
Mailing Address - Country:US
Mailing Address - Phone:714-836-6416
Mailing Address - Fax:714-836-4589
Practice Address - Street 1:512 W 17TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-3678
Practice Address - Country:US
Practice Address - Phone:714-836-6416
Practice Address - Fax:714-836-4589
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25806Medicare ID - Type Unspecified