Organization Active NPI

Ron G Soltero, MD, Inc

  • Plastic and Reconstructive Surgery Physician
  • San Diego, CA
National Provider Identifier
1912232083
Registry record updated Oct 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
A54403 Issued in CA
Legal business name
RON G SOLTERO, MD, INC
Practice address
4510 Executive Dr
Suite 105
San Diego, CA 92121-3021
Phone
(858) 457-8686
NPI assigned
Oct 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2009

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

Authorized official

Name
Raluan G Soltero, MD
Title
Physician
Phone
(858) 457-8686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X A54403 CA Primary

Addresses

Primary practice location

4510 Executive Dr
Suite 105
San Diego, CA 92121-3021

Mailing address

4510 Executive Dr
Suite 105
San Diego, CA 92121-3021
Phone (858) 457-8686

Other identifiers 1

IdentifierTypeStateIssuer
00A544030MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254873600000",
    "number": "1912232083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR",
            "address_2": "SUITE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213021",
            "telephone_number": "858-457-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR",
            "address_2": "SUITE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213021",
            "telephone_number": "858-457-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RON G SOLTERO, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-07",
        "last_updated": "2009-10-07",
        "status": "A",
        "authorized_official_last_name": "SOLTERO",
        "authorized_official_first_name": "RALUAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "858-457-8686",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A54403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A544030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; 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.