Healthcare Provider Details

I. General information

NPI: 1467671834
Provider Name (Legal Business Name): GUS WILLIAM SALBADOR III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: G. WILLIAM SALBADOR M.D.

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E 10TH AVE STE 230
EUGENE OR
97401-3304
US

IV. Provider business mailing address

401 E 10TH AVE STE 230
EUGENE OR
97401-3304
US

V. Phone/Fax

Practice location:
  • Phone: 541-684-0154
  • Fax: 541-343-6434
Mailing address:
  • Phone: 541-684-0154
  • Fax: 541-343-6434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD20717
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD20717
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: