Provider Demographics
NPI:1770045304
Name:SALAMO, REBECCA TALKIN (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:TALKIN
Last Name:SALAMO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MAGGIE
Other - Last Name:TALKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12337 SEAL BEACH BLVD # 1057
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2512 ARTESIA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3282
Practice Address - Country:US
Practice Address - Phone:424-277-2899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1763352084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry