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General NPI Number Information
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NPI Number | 1669730339
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Entity Type | Organization
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Legal Business Name | EXECUTIVE GI SERVICES
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 1320 EL CAPITAN DR SUITE 110
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City | DANVILLE
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State | CA
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Zip | 94526-6258
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Country | US
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Telephone | 925-866-9300
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Fax | 866-867-2984
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Provider Business Mailing Address
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Address Line | 12935 ALCOSTA BLVD UNIT 3888
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City | SAN RAMON
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State | CA
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Zip | 94583-6181
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Country | US
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Telephone | 925-718-6622
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Fax | 917-259-1212
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SALIM M SHELBY
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Credential | M.D.
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Telephone | 925-866-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZC0008X
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Taxonomy Name | Clinical Informatics (Pathology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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