MEDICARE: DR. NICOLE SALAME MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	192244	CA

General Provider Information

NPI Number	:	1811457013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE SALAME MD

Provider Business Mailing Address
First Line	:	3661 TORRANCE BLVD STE 104
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-4898
Country	:	US
Telephone Number	:	310-370-5670
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 N SEPULVEDA BLVD STE 100
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-5962
Country	:	US
Telephone Number	:	310-370-5670
Fax Number	:	310-601-5056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	11/10/2024

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Directions to “ DR. NICOLE SALAME MD” Practice Location

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