Provider Demographics
NPI:1679125231
Name:SALTER, AARON ISAIAH (PA-C)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:ISAIAH
Last Name:SALTER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 E OCEAN BLVD UNIT 501
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5595
Mailing Address - Country:US
Mailing Address - Phone:415-606-4199
Mailing Address - Fax:
Practice Address - Street 1:2010 E CARSON ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3040
Practice Address - Country:US
Practice Address - Phone:562-424-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-14
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA57133363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical