Healthcare Provider Details

I. General information

NPI: 1548730229
Provider Name (Legal Business Name): MARY ANNE SALVADOR RCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

9512 OSPREY WAY
GILROY CA
95020-7672
US

V. Phone/Fax

Practice location:
  • Phone: 408-851-5000
  • Fax:
Mailing address:
  • Phone: 408-512-0511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number39578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: