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General NPI Number Information
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NPI Number | 1578428603
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Entity Type | Individual
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Provider Name | MARK TERENCE ESTRADA SALAMAT
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Gender | Male
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Dates
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Enumeration Date | 12/20/2025
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 8760 W FLYNN LN
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City | GLENDALE
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State | AZ
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Zip | 85305-3406
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Country | US
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Telephone | 818-462-1842
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Fax |
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Provider Business Mailing Address
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Address Line | 8760 W FLYNN LN
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City | GLENDALE
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State | AZ
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Zip | 85305-3406
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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 |
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 332533
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License Number State | AZ
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