1285866368 NPI number — MR. SALVADOR J HORTA SR.

Table of content: MR. SALVADOR J HORTA SR. (NPI 1285866368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285866368 NPI number — MR. SALVADOR J HORTA SR.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORTA
Provider First Name:
SALVADOR
Provider Middle Name:
J
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HORTA
Provider Other First Name:
SALVADOR
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1285866368
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10230 ARTESIA BLVD
Provider Second Line Business Mailing Address:
SUITE# 100
Provider Business Mailing Address City Name:
BELLFLOWER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90706-6763
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-889-0646
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10230 ARTESIA BLVD
Provider Second Line Business Practice Location Address:
SUITE# 100
Provider Business Practice Location Address City Name:
BELLFLOWER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90706-6763
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-889-0646
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 247100000X , with the licence number:  24-4361108 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)