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Gustavo Alfonso Salcido

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1111 W Chase Ave, El Cajon, CA 92020-5710

PECOS Enrollment

This provider is enrolled in PECOS as GUSTAVO SALCIDO.

Based on the most recent information from CMS, provider Gustavo Alfonso Salcido is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1245739580
Provider Type
Individual
Full Name
Salcido, Gustavo Alfonso
Credential
FNP

Gender
Male
Sole Proprietor
No
Enumeration Date
2/1/2018
Last Updated
12/7/2023

Contact Information

Practice Location

1111 W Chase Ave, El Cajon, CA 92020-5710

(619) 515-2499

(619) 593-9164

Mailing Location

823 Gateway Center Way, San Diego, CA 92102-4541

(619) 515-2300

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95008340 California
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2009395 California

Gustavo Alfonso Salcido

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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