| Salem D.o., Inc. | |
|
18021 Sky Park Cir Ste G Irvine CA 92614-6569 | |
| (949) 260-0744 | |
| (949) 260-0750 |
| Full Name | Salem D.o., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 18021 Sky Park Cir Ste G, Irvine, California |
| Authorized Official Name and Position | Christopher Salem (OWNER) |
| Authorized Official Contact | 9492600744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salem D.o., Inc. 9330 Pecan St Cypress CA 90630-2931 Ph: (949) 260-0744 | Salem D.o., Inc. 18021 Sky Park Cir Ste G Irvine CA 92614-6569 Ph: (949) 260-0744 |
| NPI Number | 1467732057 |
|---|---|
| Provider Enumeration Date | 08/26/2011 |
| Last Update Date | 11/10/2020 |
| Medicare PECOS PAC ID | 1254505753 |
|---|---|
| Medicare Enrollment ID | O20111118000411 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467732057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A10607 (California) | Secondary |
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Chris E Salem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124273313 PECOS PAC ID: 5092852145 Enrollment ID: I20091118000745 |
| Provider Name | Rachel Renee Cliser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073011193 PECOS PAC ID: 5799037180 Enrollment ID: I20181012001874 |
| Provider Name | Mercedeh Esmaeili |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750735411 PECOS PAC ID: 7416381108 Enrollment ID: I20200106002366 |
| Provider Name | Elizabeth Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235789181 PECOS PAC ID: 9638508773 Enrollment ID: I20200410001495 |
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