Healthcare Provider Details

I. General information

NPI: 1053569228
Provider Name (Legal Business Name): PATRICIA MARIE SALMON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S BASCOM AVE VALLEY SPECIALTY CENTER, SUITE 210
SAN JOSE CA
95128-2604
US

IV. Provider business mailing address

751 S BASCOM AVE VALLEY SPECIALTY CENTER, SUITE 210
SAN JOSE CA
95128-2604
US

V. Phone/Fax

Practice location:
  • Phone: 408-793-2515
  • Fax:
Mailing address:
  • Phone: 585-281-5567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA110270
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: