Healthcare Provider Details

I. General information

NPI: 1730366261
Provider Name (Legal Business Name): DR BOB S SALK DPM PC APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CASTRO ST STE 315
SAN FRANCISCO CA
94114-1019
US

IV. Provider business mailing address

45 CASTRO ST STE 315
SAN FRANCISCO CA
94114-1019
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-0200
  • Fax: 415-565-0296
Mailing address:
  • Phone: 415-565-0200
  • Fax: 415-565-0296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4449
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4790
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4307
License Number StateCA

VIII. Authorized Official

Name: DR. BOB S SALK
Title or Position: OWNER
Credential:
Phone: 415-565-0200