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NPI Code Detail

MEDICARE: JUAN DANIEL SALDIVAR PA

MEDICARE: JUAN DANIEL SALDIVAR PA
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
1363AM0700XMedical Physician Assistant

General Provider Information

NPI Number : 1588475180
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN DANIEL SALDIVAR PA
Provider Business Mailing Address
First Line : 8100 S WALKER AVE BLDG A
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-9475
Country : US
Telephone Number : 405-632-4468
Fax Number : 405-632-0436
Provider Business Practice Location Address
First Line : 8100 S WALKER AVE BLDG A
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-9475
Country : US
Telephone Number : 405-632-4468
Fax Number : 405-632-0436
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2025
Last Update Date : 03/18/2026

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Directions to “ JUAN DANIEL SALDIVAR PA” Practice Location

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