Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A163404 | CA |
Y | 111NI0900X | Internist | A163404 | CA |
NPI | 1003311358 |
---|---|
Provider Name | Michael Salvaggio |
First Address | San Diego, CA 92103-2105 |
Second Address | Anaheim, CA 92807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2018 |
Last Update Date | 24/11/2021 |