Healthcare Provider Details

I. General information

NPI: 1245470053
Provider Name (Legal Business Name): S. J. SALFEN M.D, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2009
Last Update Date: 03/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 SAMARITAN DR SUITE 210
SAN JOSE CA
95124-4106
US

IV. Provider business mailing address

3131 S BASCOM AVE SUITE 120
CAMPBELL CA
95008-6768
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-8400
  • Fax: 408-356-0974
Mailing address:
  • Phone: 408-377-9877
  • Fax: 408-377-9893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG29984
License Number StateCA

VIII. Authorized Official

Name: SJ SALFEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 408-377-9877