Provider Demographics
NPI:1427066471
Name:SALEH, MOHAMED YASSER
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:YASSER
Last Name:SALEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4169
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93278-4169
Mailing Address - Country:US
Mailing Address - Phone:559-734-1966
Mailing Address - Fax:559-734-1967
Practice Address - Street 1:1502 W MINERAL KING AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5819
Practice Address - Country:US
Practice Address - Phone:559-734-1966
Practice Address - Fax:559-734-1967
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD35333Medicaid
CAG92492-02Medicaid