Provider Demographics
NPI:1790884633
Name:NORMA C SALCEDA, M.D. INC.
Entity Type:Organization
Organization Name:NORMA C SALCEDA, M.D. INC.
Other - Org Name:ST. ANA WOMENS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SALCEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-722-1885
Mailing Address - Street 1:3865 JASMINE AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3105
Mailing Address - Country:US
Mailing Address - Phone:310-839-4381
Mailing Address - Fax:310-815-2091
Practice Address - Street 1:1535 S WESTERN AVE STE G
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-4200
Practice Address - Country:US
Practice Address - Phone:323-733-1885
Practice Address - Fax:323-733-1875
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORMA SALCEDA, M.D. INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-21
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33244207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0981362OtherCLIA NUMBER
CA00A332441Medicaid
CAA33244OtherCALIF. MEDICAL LICENSE
CAA33244OtherCALIF. MEDICAL LICENSE
CAA33244Medicare ID - Type Unspecified