Healthcare Provider Details

I. General information

NPI: 1245168129
Provider Name (Legal Business Name): KELLY RENEE SALA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 BROOKWOOD MEDICAL CTR DR
BIRMINGHAM AL
35209-6804
US

IV. Provider business mailing address

1304 GREENBRIER RD
SAN CARLOS CA
94070-4230
US

V. Phone/Fax

Practice location:
  • Phone: 205-783-3098
  • Fax:
Mailing address:
  • Phone: 650-995-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number208600000X
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: