Provider Demographics
NPI:1407849110
Name:SALEM, AYMAN MOHAMED (MD)
Entity type:Individual
Prefix:
First Name:AYMAN
Middle Name:MOHAMED
Last Name:SALEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AYMAN
Other - Middle Name:SALEM
Other - Last Name:MOHAMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 411671
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-8671
Mailing Address - Country:US
Mailing Address - Phone:818-562-6400
Mailing Address - Fax:818-562-6405
Practice Address - Street 1:191 S BUENA VISTA ST
Practice Address - Street 2:STE 370
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4554
Practice Address - Country:US
Practice Address - Phone:818-562-6400
Practice Address - Fax:818-562-6405
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA055276207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG45065Medicare UPIN