Provider Demographics
NPI:1336245802
Name:SALCEDA, NORMA C (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:C
Last Name:SALCEDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 S WESTERN AVE STE G
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-4200
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:310-839-4381
Practice Address - Fax:310-815-2091
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33244207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0981362OtherCLIA NUMBER
CA00A332440OtherBLUE SHIELD
CA00A332441Medicaid
CA05D0963456OtherCLIA NUMBER
CA05D0971062OtherCLIA NUMBER
CA00A332443Medicaid
CA00A332442Medicaid
CAA33244OtherCALIF. MEDICAL LICENSE
CA05D0971061OtherCLIA NUMBER
CAA84452Medicare UPIN
CAA33244Medicare ID - Type Unspecified