Provider Demographics
NPI:1962442731
Name:SHEIKHOLESLAMI, HALEH (MD)
Entity Type:Individual
Prefix:DR
First Name:HALEH
Middle Name:
Last Name:SHEIKHOLESLAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HALEH
Other - Middle Name:
Other - Last Name:SHEIKHOLESLAMI-SALEHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:650-853-2250
Mailing Address - Fax:
Practice Address - Street 1:301 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-2603
Practice Address - Country:US
Practice Address - Phone:650-853-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG083269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G832690Medicare ID - Type Unspecified
CAG44522Medicare UPIN