Healthcare Provider Details

I. General information

NPI: 1831889567
Provider Name (Legal Business Name): SOULEIMAN SALAMEH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 VILLA LA JOLLA DR STE C129
LA JOLLA CA
92037-1707
US

IV. Provider business mailing address

8950 VILLA LA JOLLA DR STE C129
LA JOLLA CA
92037-1707
US

V. Phone/Fax

Practice location:
  • Phone: 858-450-5900
  • Fax:
Mailing address:
  • Phone: 858-450-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A23935
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: