Provider Demographics
NPI:1184073165
Name:ELKHAYAT, SALEM I (MD)
Entity type:Individual
Prefix:DR
First Name:SALEM
Middle Name:I
Last Name:ELKHAYAT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 FLORIN RD STE 269
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 B GALE WILSON BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3552
Practice Address - Country:US
Practice Address - Phone:707-646-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN23800207P00000X
LA312700207P00000X
CAC198529207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA312700OtherSTATE MEDICAL BOARD
FLTRN23800OtherMEDICAL LICENSE
CAC198529OtherSTATE MEDICAL BOARD