Healthcare Provider Details

I. General information

NPI: 1588438295
Provider Name (Legal Business Name): DANIEL FRANCISCO SALVAGNO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 09/29/2026
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 MOTT ST STE 100110
SAN FERNANDO CA
91340-4237
US

IV. Provider business mailing address

732 MOTT ST STE 100110
SAN FERNANDO CA
91340-4237
US

V. Phone/Fax

Practice location:
  • Phone: 818-963-5690
  • Fax: 818-963-5690
Mailing address:
  • Phone: 818-963-5690
  • Fax: 818-963-5690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95106335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: