Healthcare Provider Details

I. General information

NPI: 1467109868
Provider Name (Legal Business Name): BERNARD JOSEF MONROY SALGADO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N FLOWER ST
SANTA ANA CA
92703-2361
US

IV. Provider business mailing address

18621 WOODWIND LN
ANAHEIM CA
92807-1109
US

V. Phone/Fax

Practice location:
  • Phone: 550-714-6477
  • Fax:
Mailing address:
  • Phone: 714-600-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95193507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: