MEDICARE: GIANFRANCO C SALAZAR LVN

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	164X00000X	Licensed Vocational Nurse	240576	CA

General Provider Information

NPI Number	:	1821343419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIANFRANCO C SALAZAR LVN

Provider Business Mailing Address
First Line	:	1003 VAN PELT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90063-1335
Country	:	US
Telephone Number	:	714-365-7794
Fax Number	:

Provider Business Practice Location Address
First Line	:	1003 VAN PELT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90063-1335
Country	:	US
Telephone Number	:	714-365-7794
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2012
Last Update Date	:	08/03/2013

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