Provider Demographics
NPI:1952132268
Name:ALLAHBACHAYO, SALIMA
Entity type:Individual
Prefix:DR
First Name:SALIMA
Middle Name:
Last Name:ALLAHBACHAYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W FOOTHILL BLVD # PC204
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-1885
Mailing Address - Country:US
Mailing Address - Phone:626-914-8720
Mailing Address - Fax:
Practice Address - Street 1:1000 W FOOTHILL BLVD # PC204
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-1885
Practice Address - Country:US
Practice Address - Phone:626-914-8720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily