| Doctor Clint H. Salo Inc. | |
|
101 S Kraemer Blvd Ste 110 Placentia CA 92870-6109 | |
| (714) 995-0359 | |
| Not Available |
| Full Name | Doctor Clint H. Salo Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 S Kraemer Blvd Ste 110, Placentia, California |
| Authorized Official Name and Position | Clint Harold Salo (OWNER) |
| Authorized Official Contact | 7023542422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctor Clint H. Salo Inc. 17962 Sequoia Cir Yorba Linda CA 92886-3357 Ph: (702) 354-2422 | Doctor Clint H. Salo Inc. 101 S Kraemer Blvd Ste 110 Placentia CA 92870-6109 Ph: (714) 995-0359 |
| NPI Number | 1932639192 |
|---|---|
| Provider Enumeration Date | 06/19/2017 |
| Last Update Date | 09/07/2017 |
| Medicare PECOS PAC ID | 1658644992 |
|---|---|
| Medicare Enrollment ID | O20170907002170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932639192 | NPI | - | NPPES |
| 20A12121 | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Clint H Salo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811159221 PECOS PAC ID: 5193988301 Enrollment ID: I20120529000178 |
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