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General NPI Number Information
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NPI Number | 1851083539
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Entity Type | Individual
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Provider Name | SALVADOR DE LA PENA MUNOZ
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Gender | Male
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 2525 GRAND AVE
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City | LONG BEACH
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State | CA
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Zip | 90815-1765
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Country | US
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Telephone | 562-570-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 GRAND AVE
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City | LONG BEACH
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State | CA
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Zip | 90815-1765
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Country | US
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Telephone | 562-570-4000
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 564780
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95262748
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License Number State | CA
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