Provider Demographics
NPI:1346494010
Name:SALUGEN MEDICAL GROUP
Entity Type:Organization
Organization Name:SALUGEN MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SELLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:415-379-6100
Mailing Address - Street 1:4660 LAJOLLA VILLAGE DRIVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122
Mailing Address - Country:US
Mailing Address - Phone:415-379-6100
Mailing Address - Fax:415-379-6200
Practice Address - Street 1:2250 HAYES ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1078
Practice Address - Country:US
Practice Address - Phone:415-379-6100
Practice Address - Fax:415-379-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty