Basic Information
Provider Information
NPI: 1295759355
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOLIS
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 325 DISTEL CIR
Address2:  
City: LOS ALTOS
State: CA
PostalCode: 940221408
CountryCode: US
TelephoneNumber: 9257767725
FaxNumber: 9257646387
Practice Location
Address1: 4053 LONE TREE WAY STE 200
Address2:  
City: ANTIOCH
State: CA
PostalCode: 945316210
CountryCode: US
TelephoneNumber: 9257767725
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/26/2006
LastUpdateDate: 05/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X937101CAY Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
A8955201CASTATE MEDICAL LICENSEOTHER
BS907002001CAFEDERAL DEA LICENSEOTHER


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