MEDICARE: REBECCA SALAMO 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	2084P0804X	Child & Adolescent Psychiatry Physician
2	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1467283614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REBECCA SALAMO MD INC

Provider Business Mailing Address
First Line	:	12337 SEAL BEACH BLVD # 1057
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2512 ARTESIA BLVD STE 320
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3282
Country	:	US
Telephone Number	:	424-277-2899
Fax Number	:

Authorized Official
Title or Position	:	CEO - OWNER
Name	:	REBECCA SALAMO
Credential	:	MD
Telephone Number	:	424-277-2899

Provider Enumeration Date	:	08/09/2024
Last Update Date	:	04/22/2025

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