Dr. Clint Harold Salo

Psychiatry Anaheim Global Medical Center NPI1811159221

Summary

About

Dr. Clint Harold Salo specialises in Psychiatry. He currently works at Anaheim Global Medical Center in California.

Provider Details

NPI Number 1811159221
Provider Name Clint Harold Salo
Credential
Specialization Psychiatry
Medical School Name Other
Graduation Year 2008
Gender M
Entity Type Individual
PAC ID by PECOS 5193988301
Professional Enrollment ID I20120529000178
Enumeration Date 06/26/2008
Last Update Date 02/23/2015

Contact Details

Business Practice address 17782 COWAN, Irvine,
92614-6030 California View on Google Map
Business Practice phone 949-722-7118
Business Practice fax 949-722-7119
Mailing address PO BOX 18228, Irvine,
92623-8228 California View on Google Map
Other phone 949-955-2101
Other fax 949-390-6519
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for Clint Harold Salo Update NPI

Payments

Total Payment Worth

$4,468.61
from 194 payments in the last 6 years

Total Cash or Cash Equivalent

$467.44
from 31 payments in the last 6 years

Total In-kind Items & Services

$4,001.17
from 163 payments in the last 6 years

Hospital Affilitation

Anaheim Global Medical Center in Irvine

Irvine, California

Education & Training

Other

Psychiatry, 2008

Group Affiliation

Organization Name PECOS PAC ID Members
Progeny Psychiatric Clinic A Medical Corporation 4688904592 14

Public Reporting for Performance Scores

More Details

Final MIPS Score

17.19 out of 100

Score Breakdown

Quality Category Score 15
PI Category Score 0

 

IA Category Score 0
Cost Category Score 0
Total Patients: 56
Source of Scores: group
Newsletter for Healthcare Professionals

Provider Taxonomy Details

Primary Taxonomy
Taxonomy
License No.
20A12121 (California)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1811159221
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor N
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Salo
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Clint
The first name of the provider, if the provider is an individual.
Provider Credential Text DO
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address PO BOX 18228
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Irvine
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name California
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 92623-8228
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 949-955-2101
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 949-390-6519
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address 17782 COWAN
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Irvine
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name California
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 92614-6030
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 949-722-7118
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 949-722-7119
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 06/26/2008
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 02/23/2015
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 2084P0800X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Healthcare Provider Taxonomy #1
Provider License Number 1 20A12121
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 CA
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.