Provider Demographics
NPI:1629136544
Name:GALAL SALEM MD INC
Entity Type:Organization
Organization Name:GALAL SALEM MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GALAL
Authorized Official - Middle Name:N
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-562-2900
Mailing Address - Street 1:5985 FLORENCE AVE
Mailing Address - Street 2:#N
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201
Mailing Address - Country:US
Mailing Address - Phone:323-562-2900
Mailing Address - Fax:323-773-1874
Practice Address - Street 1:5985 FLORENCE AVE
Practice Address - Street 2:#N
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201
Practice Address - Country:US
Practice Address - Phone:323-562-2900
Practice Address - Fax:323-773-1874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66970207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1987235Medicaid
CAW16383Medicare PIN
CA1987235Medicaid