Provider Demographics
NPI:1841383817
Name:SALIMPOUR, RALPH (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:SALIMPOUR
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 1:15477 VENTURA BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3006
Mailing Address - Country:US
Mailing Address - Phone:818-907-0322
Mailing Address - Fax:818-205-2585
Practice Address - Street 1:15477 VENTURA BLVD FL 3
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3006
Practice Address - Country:US
Practice Address - Phone:818-907-0322
Practice Address - Fax:818-205-2585
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36971208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF22777Medicare UPIN