Provider Demographics
NPI:1326363565
Name:HASSANALI, SALIMA (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:SALIMA
Middle Name:
Last Name:HASSANALI
Suffix:
Gender:F
Credentials:DO, MPH
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:75 REMITTANCE DR
Mailing Address - Street 2:DEPARTMENT 6008
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-6008
Mailing Address - Country:US
Mailing Address - Phone:562-282-1419
Mailing Address - Fax:562-920-4642
Practice Address - Street 1:3851 KATELLA AVE
Practice Address - Street 2:STE 155
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3309
Practice Address - Country:US
Practice Address - Phone:562-344-1350
Practice Address - Fax:562-344-1354
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVDO 1585207R00000X
CA20A11645207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1326363565Medicaid
NV1326363565Medicaid
NVFD444X (CQ328B)Medicare PIN
NVFD444ZMedicare PIN