Healthcare Provider Details

I. General information

NPI: 1144689027
Provider Name (Legal Business Name): VICTOR SALVADOR VELASCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2016
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 CAMPISI WAY
CAMPBELL CA
95008-2340
US

IV. Provider business mailing address

910 CAMPISI WAY STE 2A
CAMPBELL CA
95008-2351
US

V. Phone/Fax

Practice location:
  • Phone: 408-827-4274
  • Fax:
Mailing address:
  • Phone: 408-827-4274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberA140799
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberA140799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: