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NPI Code Detail

MEDICARE: SALEM D.O., INC.

MEDICARE: SALEM D.O., 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
1207Q00000XFamily Medicine Physician20A10607CA
2207QG0300XGeriatric Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1467732057
Entity Type Code : Organization
Provider Name (Legal Business Name) : SALEM D.O., INC.
Provider Business Mailing Address
First Line : 9330 PECAN ST
Second Line :
City : CYPRESS
State : CA
Zip : 90630-2931
Country : US
Telephone Number : 949-260-0744
Fax Number : 949-260-0750
Provider Business Practice Location Address
First Line : 18021 SKY PARK CIR STE G
Second Line :
City : IRVINE
State : CA
Zip : 92614-6569
Country : US
Telephone Number : 949-260-0744
Fax Number : 949-260-0750
Authorized Official
Title or Position : OWNER
Name : CHRISTOPHER SALEM
Credential : D.O.
Telephone Number : 949-260-0744
Provider Enumeration Date : 08/26/2011
Last Update Date : 11/10/2020

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Directions to “SALEM D.O., INC. ” Practice Location

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