Healthcare Provider Details

I. General information

NPI: 1477524601
Provider Name (Legal Business Name): ALMA ROSA SALAZAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9041 MAGNOLIA AVE SUITE 203
RIVERSIDE CA
92503-3900
US

IV. Provider business mailing address

9041 MAGNOLIA AVE SUITE 203
RIVERSIDE CA
92503-3900
US

V. Phone/Fax

Practice location:
  • Phone: 951-688-0361
  • Fax: 951-688-6812
Mailing address:
  • Phone: 951-688-0361
  • Fax: 951-688-6812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA64482
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: