1336245802 NPI number — DR. NORMA C SALCEDA M.D.

Table of content: DR. NORMA C SALCEDA M.D. (NPI 1336245802)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336245802 NPI number — DR. NORMA C SALCEDA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALCEDA
Provider First Name:
NORMA
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336245802
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1535 S WESTERN AVE STE G
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90006-4200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-839-4381
Provider Business Mailing Address Fax Number:
310-815-2091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1535 S WESTERN AVE STE G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90006-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-839-4381
Provider Business Practice Location Address Fax Number:
310-815-2091
Provider Enumeration Date:
09/15/2006

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: 207V00000X , with the licence number:  A33244 , 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)

  • Identifier: 05D0981362 . This is a "CLIA NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00A332440 . This is a "BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00A332441 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05D0963456 . This is a "CLIA NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 05D0971062 . This is a "CLIA NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00A332443 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00A332442 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: A33244 . This is a "CALIF. MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 05D0971061 . This is a "CLIA NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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