Provider Demographics
NPI:1730169756
Name:SALUD PARA LA GENTE
Entity type:Organization
Organization Name:SALUD PARA LA GENTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALISTRERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-728-8250
Mailing Address - Street 1:PO BOX 1870
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95077-1870
Mailing Address - Country:US
Mailing Address - Phone:831-728-8250
Mailing Address - Fax:831-728-8266
Practice Address - Street 1:204 EAST BEACH STREET
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076
Practice Address - Country:US
Practice Address - Phone:831-728-0222
Practice Address - Fax:831-728-8266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000162261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70246FMedicaid
CAEAP70246FOtherMEDICAL EAPC STATE PROGRA
CABCP70246FOtherMEDICAL STATE BREAST CANC
CAHAP70246FOtherMEDICAL FAMILY PACK HEALT
CAZZZ97418ZOtherBLUE CROSS BLUE SHIELD
CAHAP70246FOtherMEDICAL FAMILY PACK HEALT
CA051931Medicare Oscar/Certification