MEDICARE: GUSTAV SALKINDER M.D.

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	174400000X	Specialist	G073167	CA

General Provider Information

NPI Number	:	1285854778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUSTAV SALKINDER M.D.

Provider Business Mailing Address
First Line	:	16250 VENTURA BLVD
Second Line	:	STE 255
City	:	ENCINO
State	:	CA
Zip	:	91436-2289
Country	:	US
Telephone Number	:	323-655-1605
Fax Number	:	323-655-1621

Provider Business Practice Location Address
First Line	:	7855 SANTA MONICA BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5344
Country	:	US
Telephone Number	:	323-655-1605
Fax Number	:	323-655-1621

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	10/03/2019

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