Healthcare Provider Details

I. General information

NPI: 1265583587
Provider Name (Legal Business Name): MICHAEL SALVATORE NUZZO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 JADE ST STE 100
CAPITOLA CA
95010-3940
US

IV. Provider business mailing address

340 DARDANELLI LN STE 100
LOS GATOS CA
95032-1418
US

V. Phone/Fax

Practice location:
  • Phone: 831-475-4024
  • Fax:
Mailing address:
  • Phone: 408-412-8110
  • Fax: 408-412-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberCDRH.0072101
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number23242
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberTP995
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number75147
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA119628
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: