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General NPI Number Information
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NPI Number | 1215829122
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Entity Type | Organization
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Legal Business Name | SALAR HAKHAM, D.O., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 1417 WEST BEVERLY BLVD SUITE 106
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City | MONTEBELLO
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State | CA
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Zip | 90640
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Country | US
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Telephone | 626-657-8002
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Fax |
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Provider Business Mailing Address
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Address Line | 324 S BEVERLY DR STE 345
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4822
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Country | US
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Telephone | 626-657-8002
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING OFFICER
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Name | GABRIELLE GONZALEZ
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Credential |
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Telephone | 909-684-4404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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