MEDICARE: GABRIEL SALGADO MURRIETA

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	122300000X	Dentist

General Provider Information

NPI Number	:	1720958200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GABRIEL SALGADO MURRIETA

Provider Business Mailing Address
First Line	:	2013 DAIRY MART RD UNIT 3
Second Line	:
City	:	SAN YSIDRO
State	:	CA
Zip	:	92173-1848
Country	:	US
Telephone Number	:	619-209-8924
Fax Number	:	916-625-1368

Provider Business Practice Location Address
First Line	:	VIARAPIDA PONIENTE 4246
Second Line	:	STE 13
City	:	TIJUANA
State	:	BAJA CALIFORNIA
Zip	:	22010
Country	:	MX
Telephone Number	:
Fax Number	:

Authorized Official
Title or Position	:	MANNAGER
Name	:	HECTOR GUSTAVO MORALES
Credential	:
Telephone Number	:	619-209-8924

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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