Healthcare Provider Details

I. General information

NPI: 1811183296
Provider Name (Legal Business Name): SALEM NEUROSURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S BUENA VISTA ST SUITE 410
BURBANK CA
91505-4569
US

IV. Provider business mailing address

201 S BUENA VISTA ST SUITE 410
BURBANK CA
91505-4569
US

V. Phone/Fax

Practice location:
  • Phone: 818-562-6400
  • Fax: 818-562-6405
Mailing address:
  • Phone: 818-562-6400
  • Fax: 885-626-4058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA55276
License Number StateCA

VIII. Authorized Official

Name: DR. AYMEN M SALEM
Title or Position: CEO
Credential: M.D.
Phone: 818-562-6400