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General NPI Number Information
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NPI Number | 1801059845
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Entity Type | Organization
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Legal Business Name | SALAS MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 973 SEQUOIA AVE
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City | LINDSAY
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State | CA
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Zip | 93247-1422
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Country | US
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Telephone | 559-784-6878
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Fax | 559-784-1592
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Provider Business Mailing Address
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Address Line | 973 SEQUOIA AVE.
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City | LINDSAY
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State | CA
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Zip | 93247-1422
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Country | US
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Telephone | 559-784-6878
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Fax | 559-784-1592
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JOSE R SALAS
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Credential | M.D.
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Telephone | 559-784-6878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A38943
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License Number State | CA
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