Provider Demographics
NPI:1730366261
Name:DR BOB S SALK DPM PC APC
Entity type:Organization
Organization Name:DR BOB S SALK DPM PC APC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:S
Authorized Official - Last Name:SALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-565-0200
Mailing Address - Street 1:45 CASTRO ST STE 315
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1019
Mailing Address - Country:US
Mailing Address - Phone:415-565-0200
Mailing Address - Fax:415-565-0296
Practice Address - Street 1:45 CASTRO ST STE 315
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1019
Practice Address - Country:US
Practice Address - Phone:415-565-0200
Practice Address - Fax:415-565-0296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4449213ES0103X
CAE4790213ES0103X
261Q00000X
CAE4307213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4407380001Medicare NSC