MEDICARE: CLINICA DE SALUD DEL VALLE DE SALINAS

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
1	261QF0400X	Federally Qualified Health Center (FQHC)	070000264	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376684456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA DE SALUD DEL VALLE DE SALINAS

Provider Business Mailing Address
First Line	:	55 PLAZA CIR STE A
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93901-2952
Country	:	US
Telephone Number	:	831-757-8689
Fax Number	:	831-757-3721

Provider Business Practice Location Address
First Line	:	122 SAN ANTONIO DRIVE
Second Line	:
City	:	KING CITY
State	:	CA
Zip	:	93930-2942
Country	:	US
Telephone Number	:	831-385-5945
Fax Number	:	831-385-0767

Authorized Official
Title or Position	:	CEO
Name	:	DR. MAXIMILIANO CUEVAS
Credential	:	M.D.
Telephone Number	:	831-757-8689

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	06/06/2024

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