Healthcare Provider Details

I. General information

NPI: 1982966883
Provider Name (Legal Business Name): SALMA AHMED FARUKHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 N SANTIAGO BLVD STE 100
ORANGE CA
92867-1859
US

IV. Provider business mailing address

2680 N SANTIAGO BLVD STE 100
ORANGE CA
92867-1859
US

V. Phone/Fax

Practice location:
  • Phone: 714-602-7615
  • Fax: 714-509-1377
Mailing address:
  • Phone: 714-602-7615
  • Fax: 714-509-1377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA130994
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: