Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath |
NPI | 1225503543 |
---|---|
Provider Name | Mr. Miguel Angel Salas |
First Address | Granada Hills, CA 91344 |
Second Address | Granada Hills, CA 91344 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2018 |
Last Update Date | 13/10/2018 |