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General NPI Number Information
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NPI Number | 1255183943
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Entity Type | Individual
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Provider Name | ROQUE GONZALEZ SALDIVAR JR.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 3525 PACIFIC COAST HWY STE N
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City | TORRANCE
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State | CA
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Zip | 90505-6657
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Country | US
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Telephone | 310-534-1113
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 W 152ND ST
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City | COMPTON
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State | CA
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Zip | 90220-2820
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Country | US
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Telephone | 310-527-1083
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 5846
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License Number State | CA
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