Provider Demographics
NPI:1922199280
Name:SALAZAR, JOE L (RCP,CRT)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:L
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:RCP,CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 PINTURA CR WEST
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-6801
Mailing Address - Country:US
Mailing Address - Phone:760-409-7629
Mailing Address - Fax:760-322-2088
Practice Address - Street 1:897 WEST VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324
Practice Address - Country:US
Practice Address - Phone:909-254-2780
Practice Address - Fax:909-254-2777
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ18253ZMedicare ID - Type Unspecified