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NPI Code Detail

MEDICARE: MR. RENE SALDIVAR SR.

MEDICARE: MR. RENE SALDIVAR SR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1164773081
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RENE SALDIVAR SR.
Provider Business Mailing Address
First Line : 258 N BLACKSTONE AVE
Second Line :
City : FRESNO
State : CA
Zip : 93701-1913
Country : US
Telephone Number : 559-274-0299
Fax Number : 559-268-0469
Provider Business Practice Location Address
First Line : 258 N BLACKSTONE AVE
Second Line :
City : FRESNO
State : CA
Zip : 93701-1913
Country : US
Telephone Number : 559-274-0299
Fax Number : 559-268-0469
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2012
Last Update Date : 01/25/2024

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