Healthcare Provider Details

I. General information

NPI: 1225503543
Provider Name (Legal Business Name): MIGUEL ANGEL SALAS NATUROPATHIC DOCTOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL SALAS

II. Dates (important events)

Enumeration Date: 10/13/2018
Last Update Date: 10/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 WOODLEY AVE. SUITE 103 & 104
GRANADA HILLS CA
91344
US

IV. Provider business mailing address

10315 WOODLEY AVE. SUITE 103 & 104
GRANADA HILLS CA
91344
US

V. Phone/Fax

Practice location:
  • Phone: 818-488-9551
  • Fax:
Mailing address:
  • Phone: 818-488-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: