Provider Demographics
NPI:1689431504
Name:SALMAN, CHAUNCEY (NP)
Entity Type:Individual
Prefix:
First Name:CHAUNCEY
Middle Name:
Last Name:SALMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28014 CARAWAY LN
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3900
Mailing Address - Country:US
Mailing Address - Phone:951-515-9193
Mailing Address - Fax:
Practice Address - Street 1:28014 CARAWAY LN
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:CA
Practice Address - Zip Code:91350-3900
Practice Address - Country:US
Practice Address - Phone:951-515-9193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025161363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner