Physician Compare National (NPI:1063795797)

HEALTHCARE PROVIDER: ROBERTO SALAZAR D.D.S

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1063795797
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961823141
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200526000246
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SALAZAR
	Individual professional last name
Provider First Name	ROBERTO
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOMA LINDA UNIVERSITY SCHOOL OF DENTISTRY
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	DENTIST
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	DENTIST
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1001 W SAN MARCOS BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 106C
	Group Practice or individual's line 2 address
City	SAN MARCOS
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	920784012
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y