Provider Demographics
NPI:1023013349
Name:SALBERG, JEFFREY PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PHILIP
Last Name:SALBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:STE 601
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2831
Mailing Address - Country:US
Mailing Address - Phone:818-996-5700
Mailing Address - Fax:818-996-1649
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:STE 601
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2831
Practice Address - Country:US
Practice Address - Phone:818-996-5700
Practice Address - Fax:818-996-1649
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46132207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110061982OtherRAILROAD RENDERING NUMBER
CAYYY40048YOtherBLUE SHIELD OF CALIFORNIA
CAT0796OtherRAILROAD GROUP NUMBER
CAWG46132COtherMEDICARE RENDERING NUMBER
CAYYY40048YMedicaid
CA95-3132732OtherBLUE CROSS OF CALIFORNIA
CA110061982OtherRAILROAD RENDERING NUMBER
CAYYY40048YMedicaid