MEDICARE: EGISTO SALERNO 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	207R00000X	Internal Medicine Physician	A37903	CA

General Provider Information

NPI Number	:	1477703353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EGISTO SALERNO MD INC

Provider Business Mailing Address
First Line	:	5532 EL CAJON BLVD STE 1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-3642
Country	:	US
Telephone Number	:	619-286-1426
Fax Number	:

Provider Business Practice Location Address
First Line	:	5532 EL CAJON BLVD STE 1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-3642
Country	:	US
Telephone Number	:	619-286-1426
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EGISTO SALERNO
Credential	:	MD
Telephone Number	:	619-286-1426

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	09/26/2008

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