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General NPI Number Information
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NPI Number | 1235448457
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Entity Type | Individual
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Provider Name | BRENT SALEM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/05/2010
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 133 15TH ST
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-2746
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Country | US
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Telephone | 831-373-1225
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Fax | 831-373-3705
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Provider Business Mailing Address
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Address Line | 478 LASSEN WAY
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City | MARINA
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State | CA
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Zip | 93933-5413
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Country | US
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Telephone | 319-855-0098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 90588
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S017585
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License Number State | AZ
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