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General NPI Number Information
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NPI Number | 1114126430
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Entity Type | Organization
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Legal Business Name | SALINAS VALLEY STATE PRISON
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 31625 HIGHWAY 101 S
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City | SOLEDAD
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State | CA
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Zip | 93960-9529
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Country | US
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Telephone | 831-678-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 31625 HIGHWAY 101 S
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City | SOLEDAD
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State | CA
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Zip | 93960-9529
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF DENTAL OFFICER
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Name | DR. JOHN ADAMO
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Credential | DDS
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Telephone | 831-678-5595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 34192
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 34192
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License Number State | CA
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