Healthcare Provider Details

I. General information

NPI: 1811472723
Provider Name (Legal Business Name): ANTHONY M SALOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 EL CAMINO REAL
PALO ALTO CA
94301-2302
US

IV. Provider business mailing address

4626 WILLOW RD
PLEASANTON CA
94588-8517
US

V. Phone/Fax

Practice location:
  • Phone: 650-853-3355
  • Fax:
Mailing address:
  • Phone: 408-843-7867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number25447
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: