Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 25174 | CA |
NPI | 1528219979 |
---|---|
Provider Name | Dr. Stefan Salim |
First Address | San Jose, CA 95124-2011 |
Second Address | San Jose, CA 95124-2011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2008 |
Last Update Date | 03/10/2008 |