Provider Demographics
NPI:1083934764
Name:DAOUK, SALIM JAMIL
Entity Type:Individual
Prefix:
First Name:SALIM
Middle Name:JAMIL
Last Name:DAOUK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9974 SPRING VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3304
Mailing Address - Country:US
Mailing Address - Phone:916-714-0677
Mailing Address - Fax:
Practice Address - Street 1:5610 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-1612
Practice Address - Country:US
Practice Address - Phone:916-737-0260
Practice Address - Fax:916-737-0269
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist