Healthcare Provider Details

I. General information

NPI: 1699714626
Provider Name (Legal Business Name): SALIM ASSAAD WEHBE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 12/21/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 2500 AMBULATORY CARE CENTER, OB/GYN CLINIC, UC DAVIS
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 2500 AMBULATORY CARE CENTER, OB/GYN CLINIC, UC DAVIS
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6949
  • Fax: 916-734-6031
Mailing address:
  • Phone: 916-734-6949
  • Fax: 916-734-6031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD11929
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberA106873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: