MEDICARE: JOHN R SALZMAN MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	G22265	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00G222650	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1255329637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN R SALZMAN MD INC

Provider Business Mailing Address
First Line	:	450 30TH ST
Second Line	:	DEPT G800
City	:	OAKLAND
State	:	CA
Zip	:	94609-3302
Country	:	US
Telephone Number	:	931-432-2343
Fax Number	:	931-432-4653

Provider Business Practice Location Address
First Line	:	450 30TH ST
Second Line	:	DEPT G800
City	:	OAKLAND
State	:	CA
Zip	:	94609-3302
Country	:	US
Telephone Number	:	931-432-2343
Fax Number	:	931-432-4653

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN RICHARD SALZMAN
Credential	:	MD
Telephone Number	:	931-432-2343

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	07/06/2009

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Directions to “JOHN R SALZMAN MD INC ” Practice Location

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