Provider Demographics
NPI:1043656960
Name:SALAHUDDIN, HISHAM RAZA ALIM (MD)
Entity Type:Individual
Prefix:DR
First Name:HISHAM
Middle Name:RAZA ALIM
Last Name:SALAHUDDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 W JANSS RD STE 125
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1856
Mailing Address - Country:US
Mailing Address - Phone:805-242-4884
Mailing Address - Fax:805-242-4885
Practice Address - Street 1:227 W JANSS RD STE 125
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1856
Practice Address - Country:US
Practice Address - Phone:805-242-4884
Practice Address - Fax:805-242-4885
Is Sole Proprietor?:No
Enumeration Date:2013-05-18
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV213392084N0400X
OH35.1335922084N0400X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program