Provider Demographics
NPI:1215808571
Name:SALEHI, AVA
Entity type:Individual
Prefix:
First Name:AVA
Middle Name:
Last Name:SALEHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AAVA
Other - Middle Name:
Other - Last Name:SALEHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1115 DOYLE PL
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-3240
Mailing Address - Country:US
Mailing Address - Phone:650-237-9003
Mailing Address - Fax:
Practice Address - Street 1:2516 SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4108
Practice Address - Country:US
Practice Address - Phone:408-356-0578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036580208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics