MEDICARE: MARTHA SALINAS

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1467813832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA SALINAS

Provider Business Mailing Address
First Line	:	3650 STOBER BLVD APT 215
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1595
Country	:	US
Telephone Number	:	702-472-5124
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 STOBER BLVD., #215
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1595
Country	:	US
Telephone Number	:	702-472-5124
Fax Number	:

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

Provider Enumeration Date	:	03/14/2016
Last Update Date	:	03/14/2016

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Directions to “ MARTHA SALINAS ” Practice Location

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