Provider Demographics
NPI:1457302812
Name:SALHOTRA, PREM P (MD)
Entity Type:Individual
Prefix:DR
First Name:PREM
Middle Name:P
Last Name:SALHOTRA
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:PO BOX 1809
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92286-1809
Mailing Address - Country:US
Mailing Address - Phone:760-228-1929
Mailing Address - Fax:760-228-9633
Practice Address - Street 1:57725 29 PALMS HWY
Practice Address - Street 2:SUITE 401
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3044
Practice Address - Country:US
Practice Address - Phone:760-228-1929
Practice Address - Fax:760-228-9633
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA426710207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A426711Medicare PIN
CA00A426710Medicare PIN