Provider Demographics
NPI:1629099825
Name:SALVO, JUNE SOMSIN (DO)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:SOMSIN
Last Name:SALVO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JUNE
Other - Middle Name:
Other - Last Name:SOMSIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3008 SILLECT AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6340
Mailing Address - Country:US
Mailing Address - Phone:661-861-7938
Mailing Address - Fax:
Practice Address - Street 1:5343 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0641
Practice Address - Country:US
Practice Address - Phone:661-861-7938
Practice Address - Fax:661-864-7669
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8258207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI25971Medicare UPIN