Solta Development LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

SOLTA DEVELOPMENT LLC

Practice address

4201 E 10TH St
Long Beach, CA 90804-5508

Phone

(818) 846-4469

NPI assigned

Jan 3, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Teodulo Bonzon

Title

Administrator

Phone

(818) 846-4469

Specialties & licenses 1

Addresses

Other names 1

• Long Beach Residential Doing business as

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1013556471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3013 ANNITA DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912061302",
            "telephone_number": "818-846-4469",
            "fax_number": "818-457-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 E 10TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908045508",
            "telephone_number": "818-846-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLTA DEVELOPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "BONZON",
        "authorized_official_first_name": "TEODULO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-846-4469"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Hubchart",
            "affiliation": "N",
            "endpointDescription": "HIPAA compliant app",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Protected Health Information",
            "address_1": "4201 E 10th St",
            "city": "Long Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "908045508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Long Beach Residential",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phillip Curtis Solomon, D.D.S.
• Princess Solomon
• Victoria Andrea Solomon, MD
• Melanie Michelle Solorio I
• Marjorie E Solorzano, CADDCA
• Pooneh Soltani, D.D.S
• Sheila Taj Soltani, OD
• Sara Soltanmorad, O.D.
• Nima Soltanzad
• Susan M. Somes, RN

• Mental Illness Community Based Residential Treatment Facility in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.