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General NPI Number Information
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NPI Number | 1841473071
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Entity Type | Individual
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Provider Name | JESSIE A SALAZAR MD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 200 W LEA ST
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City | HOBBS
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State | NM
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Zip | 88240-5110
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Country | US
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Telephone | 575-391-0270
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Fax | 575-391-0271
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Provider Business Mailing Address
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Address Line | 911 SUNSET DR
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City | HOLLISTER
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State | CA
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Zip | 95023-5606
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Country | US
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Telephone | 831-636-2640
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Fax | 831-636-2609
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A102245
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD20080080
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License Number State | NM
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