Provider Demographics
NPI:1336700426
Name:SALEH, MAHA
Entity Type:Individual
Prefix:
First Name:MAHA
Middle Name:
Last Name:SALEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 F ST APT 22
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-7550
Mailing Address - Country:US
Mailing Address - Phone:925-395-0278
Mailing Address - Fax:
Practice Address - Street 1:3333 F ST APT 22
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-7550
Practice Address - Country:US
Practice Address - Phone:925-395-0278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty