Provider Demographics
NPI:1629167861
Name:SALICK, BERNARD (MD,)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:SALICK
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9777 WILSHIRE BLVD
Mailing Address - Street 2:STE# 512
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1905
Mailing Address - Country:US
Mailing Address - Phone:310-967-3309
Mailing Address - Fax:310-967-3377
Practice Address - Street 1:9777 WILSHIRE BLVD
Practice Address - Street 2:STE# 512
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212
Practice Address - Country:US
Practice Address - Phone:310-967-3304
Practice Address - Fax:310-967-3377
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG10954207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA90102Medicare UPIN