Healthcare Provider Details

I. General information

NPI: 1497841795
Provider Name (Legal Business Name): SALMAN MEHBOOB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 GARDEN VIEW CT STE 204
ENCINITAS CA
92024-2478
US

IV. Provider business mailing address

621 S ILLINOIS AVE STE 103
MASON CITY IA
50401-5489
US

V. Phone/Fax

Practice location:
  • Phone: 760-452-6334
  • Fax: 760-634-9755
Mailing address:
  • Phone: 712-294-7020
  • Fax: 712-294-7022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD425449
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA119955
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD-41030
License Number StateIA
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA119955
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: