Provider Demographics
NPI:1194558031
Name:SOLIDARITUS HEALTH CALIFORNIA PC
Entity type:Organization
Organization Name:SOLIDARITUS HEALTH CALIFORNIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-304-6764
Mailing Address - Street 1:1025 CONNECTICUT AVE NW STE 907
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5434
Mailing Address - Country:US
Mailing Address - Phone:703-454-8063
Mailing Address - Fax:
Practice Address - Street 1:988 EL CAMINO REAL STE 8
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-3315
Practice Address - Country:US
Practice Address - Phone:650-456-9469
Practice Address - Fax:650-447-1564
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOLIDARITUS HEALTH CALIFORNIA PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty