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General NPI Number Information
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NPI Number | 1770022196
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Entity Type | Individual
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Provider Name | WALAA M SALEM
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Gender | Female
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 400 S SEPULVEDA BLVD
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-6814
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Country | US
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Telephone | 310-937-4352
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Fax | 866-601-5352
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Provider Business Mailing Address
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Address Line | 7316 VIA LORADO
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-4464
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Country | US
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Telephone | 310-293-0238
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Fax | 866-601-5352
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 43774
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License Number State | CA
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