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General NPI Number Information
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NPI Number | 1972936755
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Entity Type | Organization
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Legal Business Name | SALEM HARAKE M.D., INC.
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 18445 VANOWEN ST
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City | RESEDA
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State | CA
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Zip | 91335-5324
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Country | US
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Telephone | 818-708-8484
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Fax | 818-881-7451
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Provider Business Mailing Address
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Address Line | 18445 VANOWEN ST
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City | RESEDA
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State | CA
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Zip | 91335-5324
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Country | US
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Telephone | 818-708-8484
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Fax | 818-881-7451
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Authorized Official
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Title or Position | PHYSICIAN/CEO/OWNER
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Name | DR. SALEM NOUR HARAKE
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Credential | M.D.
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Telephone | 818-708-8484
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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 | A80782
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A80782
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License Number State | CA
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