Healthcare Provider Details

I. General information

NPI: 1548156078
Provider Name (Legal Business Name): SHELLEY SALPETER MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S NORFOLK ST STE 350
SAN MATEO CA
94403-1171
US

IV. Provider business mailing address

215 BROOKWOOD RD
WOODSIDE CA
94062-2304
US

V. Phone/Fax

Practice location:
  • Phone: 650-532-2321
  • Fax: 650-532-2333
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHELLEY RUTH SALPETER
Title or Position: OWNER
Credential: MD
Phone: 650-532-2321