Healthcare Provider Details

I. General information

NPI: 1821599689
Provider Name (Legal Business Name): SALVADOR ARECHIGA REGISTER NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 ROSECRANS ST
SAN DIEGO CA
92110-3115
US

IV. Provider business mailing address

1934 MISSION AVE
SAN DIEGO CA
92116-4023
US

V. Phone/Fax

Practice location:
  • Phone: 858-694-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95068943
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: