Provider Demographics
NPI:1770995060
Name:SALAS, JASON ROBERT (PHARMD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ROBERT
Last Name:SALAS
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1197 CANYON DR E
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-7577
Mailing Address - Country:US
Mailing Address - Phone:661-779-3515
Mailing Address - Fax:
Practice Address - Street 1:OMNI FAMILY HEALTH
Practice Address - Street 2:210 N CHESTER AVENUE
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308
Practice Address - Country:US
Practice Address - Phone:661-237-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist