Provider Demographics
NPI:1417469735
Name:SALEH, MOHAMED AHMED (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:AHMED
Last Name:SALEH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2812
Mailing Address - Country:US
Mailing Address - Phone:510-339-2215
Mailing Address - Fax:
Practice Address - Street 1:1991 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611
Practice Address - Country:US
Practice Address - Phone:510-339-2215
Practice Address - Fax:510-339-3785
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77588183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist