Provider Demographics
NPI:1942356399
Name:SALINAS VALLEY PEDIACTRIC ASSOCATES
Entity Type:Organization
Organization Name:SALINAS VALLEY PEDIACTRIC ASSOCATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JALALI-YAZDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-424-7872
Mailing Address - Street 1:951 BLANCO CIR STE F
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4451
Mailing Address - Country:US
Mailing Address - Phone:831-424-7872
Mailing Address - Fax:831-424-7877
Practice Address - Street 1:951 BLANCO CIR STE F
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4451
Practice Address - Country:US
Practice Address - Phone:831-424-7872
Practice Address - Fax:831-424-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54278174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty