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SU SALUD CLINIC PSC
NPI 1689941932
Family Medicine in Fort Wayne, IN

Active since November 30, 2011
4101 DIPLOMAT PLAZA CTR, FORT WAYNE, IN 46806(260) 444-5695(260) 444-5665 Get Directions Write a Review

NPPES record last updated: July 16, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Su Salud Clinic Psc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SU SALUD CLINIC PSC (NPI 1689941932) is a healthcare organization registered as a family medicine in Fort Wayne, Indiana and active in the NPI registry since November 2011. The organization lists Mario Augusto Gomez, Family Practice/owner, as its authorized official.

NPPES Registry Identity

NPI1689941932
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSU SALUD CLINIC PSC
Location Address4101 DIPLOMAT PLAZA CTRFort Wayne, IN 46806-4531
Mailing Address4101 Diplomat Plaza CtrFort Wayne, IN 46806-4531 · (260) 444-5695 · Fax (260) 444-5665
Phone(260) 444-5695
Fax(260) 444-5665
Organization SubpartNo
Authorized OfficialMario Augusto GomezFamily Practice/owner · (260) 444-5695
Enumeration DateNovember 30, 2011
Last NPPES UpdateJuly 16, 2012
✔ NPI 1689941932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01056928A
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4101 DIPLOMAT PLAZA CTR, Fort Wayne, IN 46806
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Su Salud Clinic Psc's NPI number?

The NPI number for Su Salud Clinic Psc is 1689941932. It was assigned to this organization in the NPPES registry on November 30, 2011.

Where is Su Salud Clinic Psc located?

Su Salud Clinic Psc is located at 4101 Diplomat Plaza Ctr, Fort Wayne, IN 46806. The listed phone number is (260) 444-5695.

What is Su Salud Clinic Psc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Su Salud Clinic Psc was last updated on July 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.