Provider Demographics
NPI:1932834850
Name:SALEM, EMAN (DABNM, CNIM)
Entity Type:Individual
Prefix:
First Name:EMAN
Middle Name:
Last Name:SALEM
Suffix:
Gender:F
Credentials:DABNM, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 HAMPSHIRE RD APT 5
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2345
Mailing Address - Country:US
Mailing Address - Phone:832-630-5973
Mailing Address - Fax:
Practice Address - Street 1:675 HAMPSHIRE RD APT 5
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2345
Practice Address - Country:US
Practice Address - Phone:832-630-5973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-24
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2872246ZE0600X
2872246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty