Provider Demographics
NPI:1992065189
Name:SALAZAR, LUIS ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ENRIQUE
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LUIS
Other - Middle Name:ENRIQUE
Other - Last Name:SALAZAR
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4900 W SUNSET BLVD
Mailing Address - Street 2:2ND FLOOR DEPARTMENT OF UROLOGY
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5814
Mailing Address - Country:US
Mailing Address - Phone:323-783-5500
Mailing Address - Fax:323-783-7272
Practice Address - Street 1:4900 W SUNSET BLVD
Practice Address - Street 2:2ND FLOOR DEPARTMENT OF UROLOGY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5814
Practice Address - Country:US
Practice Address - Phone:323-783-5500
Practice Address - Fax:323-783-7272
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115709208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology