1578563383 NPI number — DR. CATHERINE L SALEM M.D.

Table of content: DR. CATHERINE L SALEM M.D. (NPI 1578563383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578563383 NPI number — DR. CATHERINE L SALEM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALEM
Provider First Name:
CATHERINE
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578563383
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 PASTEUR DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STANFORD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94305-2200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-723-4000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 PASTEUR DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94305-2200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-723-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  20025 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: D0042586 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: G143277 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4255520 . This is a "AETNA PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 03950 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 029345800 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6413638 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 744095 . This is a "FIRST HEALTH/CCN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1245478 13 . This is a "UNITED HC/AMERICHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 4579 . This is a "ELDER HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 43946 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 29020015 . This is a "CAREFIRST BC/BS DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 603327-01 . This is a "CAREFIRST BC/BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1057463 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 195891700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 234013 . This is a "PHCS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 501056 . This is a "NATIONAL CAPITOL PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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