NPIMap

Individual provider Active NPI

Oliver M Solomon, DO

  • Internal Medicine Physician
  • Glendora, CA
National Provider Identifier
1255403085
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A7503 Issued in CA
Practice address
130 West Route 66
Suite 326
Glendora, CA 91740
Phone
(626) 963-8588
Fax
(626) 968-8578
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A7503 CA Primary

Addresses

Primary practice location

130 West Route 66
Suite 326
Glendora, CA 91740

Mailing address

PO Box 457
San Dimas, CA 91773
Phone (909) 971-9334

Other identifiers 2

IdentifierTypeStateIssuer
20A7503OtherCAMEDICARE
00AX75030MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812001590 CA Practitioner - Internal Medicine 1052384690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Oliver M Solomon IncGroup PAC ID 1951692219, 2 clinicians

Practice addresses (Care Compare)

130 W Route 66
Suite 326
Glendora, CA 91740-6252
Phone (626) 963-8588

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7503CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Oliver M Solomon Inc Internal Medicine CurrentSince Apr 11, 2016 Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
1495 Cameron Avenue, LLC Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

130 W Route 66
Ste 326
Glendora, CA 91740
Phone (626) 963-8588

1495 W Cameron Ave
West Covina, CA 91790
Phone (626) 962-4461

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
West Haven HealthcareWest Covina, CA, CCN 056228 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 22, 2022
Jun 22, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1255403085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "91773",
            "telephone_number": "909-971-9334",
            "fax_number": "909-971-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WEST ROUTE 66",
            "address_2": "SUITE 326",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91740",
            "telephone_number": "626-963-8588",
            "fax_number": "626-968-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "OLIVER",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "20A7503",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX75030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.