Healthcare Provider Details

I. General information

NPI: 1093937930
Provider Name (Legal Business Name): LARRY ALLAN SALTZMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 03/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SCRIPPS DR SUITE 202
SACRAMENTO CA
95825-6206
US

IV. Provider business mailing address

4531 PARKRIDGE RD
SACRAMENTO CA
95822-1250
US

V. Phone/Fax

Practice location:
  • Phone: 916-927-1114
  • Fax: 916-927-3244
Mailing address:
  • Phone: 916-548-2637
  • Fax: 916-454-9394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG39735
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: