Healthcare Provider Details

I. General information

NPI: 1033072137
Provider Name (Legal Business Name): JAMALALDEEN SALEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25046 HOLLYHOCK CT
STEVENSON RANCH CA
91381-2218
US

IV. Provider business mailing address

25046 HOLLYHOCK CT
STEVENSON RANCH CA
91381-2218
US

V. Phone/Fax

Practice location:
  • Phone: 818-335-0041
  • Fax:
Mailing address:
  • Phone: 818-335-0041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: