Provider Demographics
NPI:1689048241
Name:CLINICA DE SALUD DEL VALLE DE SALINAS
Entity Type:Organization
Organization Name:CLINICA DE SALUD DEL VALLE DE SALINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MAXIMILLIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:CUEVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-757-8689
Mailing Address - Street 1:440 AIRPROT BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:126 FIFTH STREET
Practice Address - Street 2:
Practice Address - City:GONZALEZ
Practice Address - State:CA
Practice Address - Zip Code:93926
Practice Address - Country:US
Practice Address - Phone:831-757-8689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICA DE SALUD DEL VALLE DE SALINAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-19
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)