Active NPI
Alonso Dario Pezo Salazar, M.D.
- Infectious Disease Physician
- Walla Walla, WA
National Provider Identifier
1073963658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 61111818
- Practice address
- 1313 N 13TH Ave
Walla Walla, WA 99362-8817 - Phone
- (509) 525-3610
- NPI assigned
- Jun 15, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 61111818 | WA | Primary |
Addresses
Primary practice location
1313 N 13TH Ave
Walla Walla, WA 99362-8817
Mailing address
1136 Whitman St
Walla Walla, WA 99362-3463
Phone (210) 307-5688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61111818 | WA | MD | Infectious Disease Physician |
Interoperability endpoints
- apezosalazar92232@direct.phhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708214400000",
"number": "1073963658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1136 WHITMAN ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993623463",
"telephone_number": "210-307-5688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 N 13TH AVE",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993628817",
"telephone_number": "509-525-3610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEZO SALAZAR",
"first_name": "ALONSO",
"middle_name": "DARIO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-15",
"last_updated": "2024-02-18",
"certification_date": "2024-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": "WA",
"license": "61111818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.