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General NPI Number Information
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NPI Number | 1902937956
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Entity Type | Individual
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Provider Name | SUSAN MARIE SALAZAR MD
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 2100 POWELL ST STE 900
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City | EMERYVILLE
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State | CA
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Zip | 94608-1844
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Country | US
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Telephone | 510-350-2676
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Fax | 510-879-9100
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Provider Business Mailing Address
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Address Line | 703 PIER AVE STE B # 133
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-3943
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Country | US
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Telephone | 310-963-1057
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A60879
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License Number State | CA
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