Healthcare Provider Details

I. General information

NPI: 1114566247
Provider Name (Legal Business Name): SHELBY ANNE SALTSMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 N RODEO DR STE 7
BEVERLY HILLS CA
90210-4500
US

IV. Provider business mailing address

421 N RODEO DR STE 7
BEVERLY HILLS CA
90210-4500
US

V. Phone/Fax

Practice location:
  • Phone: 310-274-5372
  • Fax: 310-274-5380
Mailing address:
  • Phone: 310-274-5372
  • Fax: 310-274-5380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA61209
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number9894
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: