Healthcare Provider Details

I. General information

NPI: 1235339169
Provider Name (Legal Business Name): SALUD PARA LA GENTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E BEACH STREET
WATSONVILLE CA
95076
US

IV. Provider business mailing address

PO BOX 1750
WATSONVILLE CA
95076
US

V. Phone/Fax

Practice location:
  • Phone: 831-728-0222
  • Fax: 831-728-8266
Mailing address:
  • Phone: 831-728-8250
  • Fax: 831-728-8266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. RAMON E PENA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 831-763-3401