Provider Demographics
NPI:1508822974
Name:SALAZAR-CALDERON, VICTOR H (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:H
Last Name:SALAZAR-CALDERON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:515 W BUCKEYE RD
Mailing Address - Street 2:STE 208
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-2647
Mailing Address - Country:US
Mailing Address - Phone:602-258-3305
Mailing Address - Fax:602-257-4485
Practice Address - Street 1:515 W BUCKEYE RD
Practice Address - Street 2:STE 208
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-2647
Practice Address - Country:US
Practice Address - Phone:602-258-3305
Practice Address - Fax:602-257-4485
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ181392084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ411075Medicaid
AZ2055411OtherAETNA
AZ1Z2694OtherHEALTH NET
AZAZ0835450OtherBCBS OF AZ
AZ1Z2694OtherHEALTH NET
E66745Medicare UPIN