Healthcare Provider Details

I. General information

NPI: 1902542996
Provider Name (Legal Business Name): ARVIN NINO SALANGSANG ESPIRITU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date: 12/27/2022
Reactivation Date: 12/27/2022

III. Provider practice location address

105 E SYDNOR AVE STE 100
RIDGECREST CA
93555-5546
US

IV. Provider business mailing address

1081 N CHINA LAKE BLVD FAMILY MEDICINE CENTER
RIDGECREST CA
93555-3130
US

V. Phone/Fax

Practice location:
  • Phone: 760-446-6404
  • Fax: 760-446-6415
Mailing address:
  • Phone: 760-499-3899
  • Fax: 760-446-6404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA199252
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: