Provider Demographics
NPI:1013089655
Name:SLATKIN, NEAL ELLIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:ELLIOT
Last Name:SLATKIN
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 1:4850 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-5156
Mailing Address - Country:US
Mailing Address - Phone:408-559-5600
Mailing Address - Fax:
Practice Address - Street 1:4850 UNION AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-5156
Practice Address - Country:US
Practice Address - Phone:408-559-5600
Practice Address - Fax:408-559-5320
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG537422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G537420Medicaid
CAP01359171OtherPALMETTO GBA
CAWG53742AOtherMEDICARE ID
CAWG53742AOtherMEDICARE ID