Individual
GUSTAVO SALAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2801 'L' STREET, SACRAMENTO, CA 95816
(916) 733-3003
Mailing address
P.O. BOX 12020, WESTMINSTER, CA 92685-2020
(888) 556-5617
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17738
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA17738
—
CA
Enumeration date
08/29/2006
Last updated
03/17/2011
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