Provider Demographics
NPI:1144689027
Name:VELASCO, VICTOR SALVADOR (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:SALVADOR
Last Name:VELASCO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 N STATE ST
Mailing Address - Street 2:C/O LAURENE KWOK, OBSTETRICS & GYNECOLOGY IPT C3F107
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1029
Mailing Address - Country:US
Mailing Address - Phone:323-409-8848
Mailing Address - Fax:323-441-7219
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:C/O LAURENE KWOK, OBSTETRICS & GYNECOLOGY IPT C3F107
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1029
Practice Address - Country:US
Practice Address - Phone:323-409-8848
Practice Address - Fax:323-441-7219
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2023-06-13
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Provider Licenses
StateLicense IDTaxonomies
CAA1407992088F0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology