Provider Demographics
NPI:1063577955
Name:SOLOMON, RANDALL L (MD)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:L
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3145 GEARY BLVD
Mailing Address - Street 2:#750
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3316
Mailing Address - Country:US
Mailing Address - Phone:415-215-8657
Mailing Address - Fax:800-953-0140
Practice Address - Street 1:760 HAIGHT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3317
Practice Address - Country:US
Practice Address - Phone:415-215-8657
Practice Address - Fax:800-953-0140
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2013-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG549032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF23140Medicare UPIN