Provider Demographics
NPI:1144751728
Name:SALEM, ALI (PHARM D)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:SALEM
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10270 E TARON DR
Mailing Address - Street 2:APT. 250
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-8222
Mailing Address - Country:US
Mailing Address - Phone:773-841-8075
Mailing Address - Fax:
Practice Address - Street 1:10270 E TARON DR
Practice Address - Street 2:APT. 250
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-8222
Practice Address - Country:US
Practice Address - Phone:773-841-8075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist