Provider Demographics
NPI:1306018916
Name:A. SALSIDO CORP
Entity type:Organization
Organization Name:A. SALSIDO CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALSIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-343-0807
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:SUNSET BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90742-0586
Mailing Address - Country:US
Mailing Address - Phone:562-592-3362
Mailing Address - Fax:562-592-3372
Practice Address - Street 1:1248 E 10TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-4928
Practice Address - Country:US
Practice Address - Phone:562-599-2451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness