Provider Demographics
NPI:1245271634
Name:SALMEN, BRIAN JOHN (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:JOHN
Last Name:SALMEN
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:P.O. BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-3418
Mailing Address - Fax:
Practice Address - Street 1:250 BON AIR RD
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1702
Practice Address - Country:US
Practice Address - Phone:415-925-7301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG292782085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G292780Medicaid
CA300121757OtherRAILROAD MEDICARE
CA00G292782Medicare PIN
CA00G292785Medicare PIN
CA00G292780Medicaid
CA00G292787Medicare PIN
CA300121757OtherRAILROAD MEDICARE
CADF930YMedicare PIN
CA00G292784Medicare PIN
CA00G292788Medicare PIN
CA00G292780Medicare PIN
CA00G292786Medicare PIN