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General NPI Number Information
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NPI Number | 1548967334
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Entity Type | Individual
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Provider Name | ANGEL SALCIDO-MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 2301 7TH ST STE A
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City | LAS VEGAS
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State | NM
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Zip | 87701-4966
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Country | US
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Telephone | 505-454-9611
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Fax | 505-454-8079
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Provider Business Mailing Address
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Address Line | 105 PASEO DEL CANON W STE A
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City | TAOS
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State | NM
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Zip | 87571-6943
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Country | US
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Telephone | 575-737-5533
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Fax | 575-737-5534
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NM
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