Provider Demographics
NPI:1154362341
Name:SALINAS, EDNA KU (MD, PHD)
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:KU
Last Name:SALINAS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:EDNA
Other - Middle Name:
Other - Last Name:KU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:2809 OLIVE HWY
Mailing Address - Street 2:STE 150
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6131
Mailing Address - Country:US
Mailing Address - Phone:530-532-8180
Mailing Address - Fax:
Practice Address - Street 1:2809 OLIVE HWY
Practice Address - Street 2:STE 150
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6131
Practice Address - Country:US
Practice Address - Phone:530-532-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103035207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275343000Medicaid
FL52793OtherBCBS
CAA103035OtherCALIFORNIA LICENSE
FLAA257ZMedicare PIN
CAA103035OtherCALIFORNIA LICENSE