Organization
DOCTOR CLINT H. SALO INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLINT HAROLD SALO DO (OWNER)
(702) 354-2422
Entity
Organization
Contact information
Practice address
101 S KRAEMER BLVD STE 110, PLACENTIA, CA 92870-6109
(714) 995-0359
Mailing address
17962 SEQUOIA CIR, YORBA LINDA, CA 92886-3357
(702) 354-2422
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A12121
STATE LICENSE
CA
Enumeration date
06/19/2017
Last updated
09/07/2017
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