Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | C338090 | CA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | C33809 | CA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | C33809 | CA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | C33809 | CA |
NPI | 1851381131 |
---|---|
Provider Name | Dr. Peter B Salamon |
First Address | Sacramento, CA 95817-2307 |
Second Address | Stockton, CA 95204-5508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 08/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C338090 | (05) | CA |
A88989 | (02) |