Provider Demographics
NPI:1467283614
Name:REBECCA SALAMO MD INC
Entity type:Organization
Organization Name:REBECCA SALAMO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO - OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-277-2899
Mailing Address - Street 1:12337 SEAL BEACH BLVD # 1057
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2512 ARTESIA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3282
Practice Address - Country:US
Practice Address - Phone:424-277-2899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-09
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty