Provider Demographics
NPI:1366634032
Name:SALAZAR, CARLOS MANALO (RN, PHN)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:MANALO
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:50 IVY ST
Mailing Address - Street 2:(LECH WALESA)
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4506
Mailing Address - Country:US
Mailing Address - Phone:415-355-7427
Mailing Address - Fax:415-355-7404
Practice Address - Street 1:635 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2116
Practice Address - Country:US
Practice Address - Phone:415-206-6942
Practice Address - Fax:415-206-6851
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA500363163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator