Basic Information
| Provider Information | |||||||||
| NPI: | 1316274707 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALCEDO | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | CRISTINE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 S WELLS RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930041377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056408293 | ||||||||
| FaxNumber: | 8056401410 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 S WELLS RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930041377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056408293 | ||||||||
| FaxNumber: | 8056401410 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2009 | ||||||||
| LastUpdateDate: | 02/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 20A11241 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.