Provider Demographics
NPI:1619040219
Name:SALCEDO, EDGARDO S JR (MD)
Entity Type:Individual
Prefix:
First Name:EDGARDO
Middle Name:S
Last Name:SALCEDO
Suffix:JR
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 1:2315 STOCKTON BLVD., DEPARTMENT OF SURGERY
Mailing Address - Street 2:NAOB, SUITE 5103
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2201
Mailing Address - Country:US
Mailing Address - Phone:916-734-3980
Mailing Address - Fax:916-734-7821
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:ROOM 4206
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-7432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1168522086S0102X, 208600000X
FLFL#TRN7906208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care