MEDICARE: DR. ANNA FLOR C. SALCEDO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	12105	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	12105	OTHER	NV	STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	NV5935	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1053486472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA FLOR C. SALCEDO MD

Provider Business Mailing Address
First Line	:	PO BOX 98978
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89193-8978
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:	702-671-6883

Provider Business Practice Location Address
First Line	:	3750 S JONES BLVD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2209
Country	:	US
Telephone Number	:	702-434-8880
Fax Number	:	702-862-8880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/17/2021

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Directions to “ DR. ANNA FLOR C. SALCEDO MD” Practice Location

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