Provider Demographics
NPI:1245470053
Name:S. J. SALFEN M.D, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:S. J. SALFEN M.D, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SJ
Authorized Official - Middle Name:
Authorized Official - Last Name:SALFEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-377-9877
Mailing Address - Street 1:3131 S BASCOM AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-6768
Mailing Address - Country:US
Mailing Address - Phone:408-377-9877
Mailing Address - Fax:408-377-9893
Practice Address - Street 1:2520 SAMARITAN DR
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4106
Practice Address - Country:US
Practice Address - Phone:408-356-8400
Practice Address - Fax:408-356-0974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG29984207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44249Medicare UPIN