Provider Demographics
NPI:1619038460
Name:SALAZAR, ISAIAS FELIPE (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAIAS
Middle Name:FELIPE
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 W CLARK ST
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-1949
Mailing Address - Country:US
Mailing Address - Phone:909-981-8873
Mailing Address - Fax:
Practice Address - Street 1:2295 S VINEYARD AVE STE A
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-7926
Practice Address - Country:US
Practice Address - Phone:909-724-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26799207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26799OtherSTATE MEDICAL LICENSE