Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 11529 | CA |
NPI | 1316379118 |
---|---|
Provider Name | Alann Salvador |
First Address | Los Angeles, CA 90011-5622 |
Second Address | Los Angeles, CA 90011-5622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2013 |
Last Update Date | 02/08/2013 |