Provider Demographics
NPI:1184911612
Name:SALEEM, TAIMUR (MD)
Entity type:Individual
Prefix:DR
First Name:TAIMUR
Middle Name:
Last Name:SALEEM
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:GONDA GOLDSCHMIED VASCULAR CTR
Mailing Address - Street 2:200 UCLA MEDICAL PLAZA, SUITE 526
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-825-8778
Mailing Address - Fax:
Practice Address - Street 1:971 LAKELAND DR STE 401
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4607
Practice Address - Country:US
Practice Address - Phone:601-939-4230
Practice Address - Fax:601-664-6694
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS257902086S0129X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program