Provider Demographics
NPI:1215404058
Name:SALMAN, MOHAMMED DIAB SALMAN
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:DIAB SALMAN
Last Name:SALMAN
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 1:8990 GARFIELD ST STE 13
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3922
Mailing Address - Country:US
Mailing Address - Phone:951-688-5232
Mailing Address - Fax:
Practice Address - Street 1:8990 GARFIELD ST STE 12
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3922
Practice Address - Country:US
Practice Address - Phone:951-688-5232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH64772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist