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General NPI Number Information
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NPI Number | 1922951961
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Entity Type | Individual
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Provider Name | OMAR SALEH MUTHANNA SALEM SR.
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Gender | Male
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 2210 BELLAGIO ST
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City | DELANO
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State | CA
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Zip | 93215-9247
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Country | US
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Telephone | 209-693-3555
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 BELLAGIO ST
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City | DELANO
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State | CA
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Zip | 93215-9247
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Country | US
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Telephone |
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | M-24-26-R-005431
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License Number State | CA
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