Individual provider Active NPI

Victor Salib, MD

  • Family Medicine Physician
  • Yucaipa, CA
National Provider Identifier
1295701977
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C132336 Issued in CA
Practice address
33758 Yucaipa Blvd
Yucaipa, CA 92399
Phone
(909) 795-9747
Fax
(909) 797-3922
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C132336 CA Primary

Addresses

Primary practice location

33758 Yucaipa Blvd
Yucaipa, CA 92399

Mailing address

1615 Orange Tree LN
Redlands, CA 92374-4501
Phone (909) 786-0725

Other identifiers 1

IdentifierTypeStateIssuer
CA139015MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150127001002 CA Practitioner - Family Practice 1456397561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Emergency MedicineGroup PAC ID 8628128196, 45 clinicians

Practice addresses (Care Compare)

1295 Hamner Ave
Suite C
Norco, CA 92860-3161
Phone (951) 272-6500

Hospital & facility affiliations

  • St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C132336CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Emergency Medicine Current Accepting new patients
Southern California Emergency Medicine CurrentSince Jun 27, 2018 Accepting new patients
Beaver Medical Group P C Family Medicine CurrentSince Dec 1, 2014 Accepting new patients
Southern California Emergency Medicine CurrentSince Jun 27, 2018 Accepting new patients
Beaver Medical Group P C CurrentSince Dec 1, 2014 Accepting new patients

Locations

1181 S Mount Vernon Ave
Colton, CA 92324
Phone (909) 639-8800

1407 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-3577

1295 Hamner Ave
Ste C
Norco, CA 92860
Phone (951) 272-6500

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

33494 Oak Glen Rd
Yucaipa, CA 92399
Phone (909) 797-8900

33758 Yucaipa Blvd
Yucaipa, CA 92399
Phone (909) 795-9747

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1295701977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 ORANGE TREE LN",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744501",
            "telephone_number": "909-786-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33758 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "92399",
            "telephone_number": "909-795-9747",
            "fax_number": "909-797-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALIB",
        "first_name": "VICTOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C132336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA139015",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.