Basic Information
| Provider Information | |||||||||
| NPI: | 1841223658 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALEMI-CASTRO | ||||||||
| FirstName: | HECTOR | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 355 E 21ST ST | ||||||||
| Address2: | SUITE K | ||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924044824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098826900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 420 W FRONT ST | ||||||||
| Address2: | |||||||||
| City: | EVERGREEN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 364013279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2515782000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 02/13/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 22418 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A73975 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 144710 | 05 | AL | MEDICAID |