Solandsoul Medical Group, a Professional Medical Corporation

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SOLANDSOUL MEDICAL GROUP, A PROFESSIONAL MEDICAL CORPORATION

Practice address

14642 Newport Ave Ste 105
Tustin, CA 92780-6058

Phone

(949) 527-6410

Fax

(714) 486-2309

NPI assigned

Oct 15, 2019

Organization subpart

No

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

Authorized official

Name

Linda Mack

Title

Administrator

Phone

(949) 527-6400

Specialties & licenses 1

Addresses

Other names 1

• Luzwave Integrative Medicine Doing business as

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1659913291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE STE 105",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806058",
            "telephone_number": "949-527-6400",
            "fax_number": "714-486-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE STE 105",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806058",
            "telephone_number": "949-527-6410",
            "fax_number": "714-486-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLANDSOUL MEDICAL GROUP, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "949-527-6400"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luzwave Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Luzwave Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• So Youn Min DDS Inc
• Socal Medical, Inc
• Social Collaborative LLC
• David L Sodaro, M.D.
• Dorene Lynn Sokolik
• Mayra Yaloha Solano, M.P.T.
• Mary Susanna Soliman, LCSW
• Isaac Solis
• Sonisk Pain Management Inc
• Soo Health Care, Inc.

• Medical Specialty Clinic/Center in Tustin, CA
• Providers in Tustin, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.