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Organization
SOLANO GATEWAY MEDICAL GROUP INC
Active
Organization
SOLANO GATEWAY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEIL MENDELSON M.D. (CEO / CFO)
(865) 693-1000
Entity
Organization
Contact information
Practice address
1200 B GALE WILSON BLVD, FAIRFIELD, CA 94533-3552
(925) 924-1600
Mailing address
PO BOX 635198, CINCINNATI, OH 45263-5198
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC3984
MEDICARE RR
CA
05
—
GR0092091
—
CA
01
—
ZZZ05562Z
BS CALIFORNIA
CA
Enumeration date
06/14/2006
Last updated
09/18/2025
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