Provider Demographics
NPI:1235360447
Name:FAKHRI M. SALEM, M.D., INC.
Entity Type:Organization
Organization Name:FAKHRI M. SALEM, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FAKHRI
Authorized Official - Middle Name:M
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD, INC
Authorized Official - Phone:619-260-0862
Mailing Address - Street 1:550 WASHINGTON ST.
Mailing Address - Street 2:SUITE 641
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2229
Mailing Address - Country:US
Mailing Address - Phone:619-260-0862
Mailing Address - Fax:619-299-3923
Practice Address - Street 1:550 WASHINGTON ST.
Practice Address - Street 2:SUITE 641
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2229
Practice Address - Country:US
Practice Address - Phone:619-260-0862
Practice Address - Fax:619-299-3923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50050208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty