Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1063046647 |
---|---|
Provider Name | Elizabeth Angel Salcedo |
First Address | Tulare, CA 93274-6243 |
Second Address | Tulare, CA 93274-4508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2020 |
Last Update Date | 23/02/2020 |