MEDICARE: CARLOS LEIVA SALINAS M.D.

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	2085N0700X	Neuroradiology Physician	01019542088	VA
2	2085N0700X	Neuroradiology Physician	A154586	CA
3	2085N0700X	Neuroradiology Physician	2016041478	MO
4	2085R0202X	Diagnostic Radiology Physician	V7558	TX
5	2085N0700X	Neuroradiology Physician	2025-00218	NC

General Provider Information

NPI Number	:	1477978534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS LEIVA SALINAS M.D.

Provider Business Mailing Address
First Line	:	2360 PANORAMA TER
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-2536
Country	:	US
Telephone Number	:	434-882-5922
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 SAN PABLO ST LOWR LEVEL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5310
Country	:	US
Telephone Number	:	323-442-8500
Fax Number	:

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

Provider Enumeration Date	:	02/26/2014
Last Update Date	:	06/01/2026

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