Individual
ISRAEL IVAN SALCIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 QUINTARD ST APT 53, CHULA VISTA, CA 91911-4933
(619) 410-9926
Mailing address
240 QUINTARD ST APT 53, CHULA VISTA, CA 91911-4933
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
Y4560897
CA
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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