Provider Demographics
NPI:1558833830
Name:SALEK, MEHRAN (MD)
Entity Type:Individual
Prefix:
First Name:MEHRAN
Middle Name:
Last Name:SALEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMAD HASSAN
Other - Middle Name:
Other - Last Name:FANI-SALEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:990 CRESCENT MEADOWS CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4957
Mailing Address - Country:US
Mailing Address - Phone:702-576-7097
Mailing Address - Fax:
Practice Address - Street 1:990 CRESCENT MEADOWS CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4957
Practice Address - Country:US
Practice Address - Phone:702-576-7097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18493207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology