Healthcare Provider Details

I. General information

NPI: 1114173648
Provider Name (Legal Business Name): ADLER MALIGAYA SALAZAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 HYPERION AVE
LOS ANGELES CA
90027-4738
US

IV. Provider business mailing address

1824 HYPERION AVE
LOS ANGELES CA
90027-4738
US

V. Phone/Fax

Practice location:
  • Phone: 626-590-0505
  • Fax:
Mailing address:
  • Phone: 626-590-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA97482
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: