Healthcare Provider Details

I. General information

NPI: 1144725854
Provider Name (Legal Business Name): RAFIK BAHGAT SALAMA SALEH MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RAFIK SALEH MD, MPH

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E FOOTHILL BLVD DEPT OF
RIALTO CA
92376-5230
US

IV. Provider business mailing address

850 E FOOTHILL BLVD
RIALTO CA
92376-5230
US

V. Phone/Fax

Practice location:
  • Phone: 909-421-9495
  • Fax: 909-421-9466
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number63526
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA174395
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR78986
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberA174395
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: