Healthcare Provider Details

I. General information

NPI: 1710187968
Provider Name (Legal Business Name): MICHAEL F SALIB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9990 COUNTY FARM RD
RIVERSIDE CA
92503-3542
US

IV. Provider business mailing address

905 MONO WAY
SONORA CA
95370-5206
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-4741
  • Fax:
Mailing address:
  • Phone: 209-928-5461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberN4059
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA106234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: