Provider Demographics
NPI:1407813785
Name:SALEK, NIZAR (MD)
Entity Type:Individual
Prefix:
First Name:NIZAR
Middle Name:
Last Name:SALEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41593 WINCHESTER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4860
Mailing Address - Country:US
Mailing Address - Phone:951-693-0666
Mailing Address - Fax:951-693-0664
Practice Address - Street 1:41593 WINCHESTER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4860
Practice Address - Country:US
Practice Address - Phone:951-693-0666
Practice Address - Fax:951-693-0664
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine