Provider Demographics
NPI:1285866368
Name:HORTA, SALVADOR J SR
Entity Type:Individual
Prefix:MR
First Name:SALVADOR
Middle Name:J
Last Name:HORTA
Suffix:SR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:SALVADOR
Other - Middle Name:J
Other - Last Name:HORTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10230 ARTESIA BLVD
Mailing Address - Street 2:SUITE# 100
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6763
Mailing Address - Country:US
Mailing Address - Phone:562-889-0646
Mailing Address - Fax:
Practice Address - Street 1:10230 ARTESIA BLVD
Practice Address - Street 2:SUITE# 100
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6763
Practice Address - Country:US
Practice Address - Phone:562-889-0646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24-4361108247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist