Healthcare Provider Details

I. General information

NPI: 1467685826
Provider Name (Legal Business Name): SHALA AMAL SALEM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 LOMITA BLVD
TORRANCE CA
90505-3884
US

IV. Provider business mailing address

3720 LOMITA BLVD
TORRANCE CA
90505-3884
US

V. Phone/Fax

Practice location:
  • Phone: 310-376-7000
  • Fax:
Mailing address:
  • Phone: 310-376-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA108615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: