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General NPI Number Information
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NPI Number | 1619865995
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Entity Type | Individual
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Provider Name | ROMAN AGUON SALAS RN, NP, CNS
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Gender | Male
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 5955 ZEAMER AVE
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City | ELMENDORF AFB
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State | AK
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Zip | 99506-3702
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Country | US
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Telephone | 907-580-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 11327 FORTINO PT
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City | SAN DIEGO
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State | CA
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Zip | 92131-4229
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Country | US
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Telephone | 619-753-9015
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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 | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 5210
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364SC0200X
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Taxonomy Name | Critical Care Medicine Clinical Nurse Specialist
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License Number | 5210
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 95035330
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 5210
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number | 5210
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95035330
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License Number State | CA
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