Provider Demographics
NPI:1891934832
Name:SALIMINEJAD, MEHRDAD (MD)
Entity type:Individual
Prefix:DR
First Name:MEHRDAD
Middle Name:
Last Name:SALIMINEJAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 WORSHAM AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1766
Mailing Address - Country:US
Mailing Address - Phone:562-595-5421
Mailing Address - Fax:562-426-2862
Practice Address - Street 1:3833 WORSHAM AVE STE 300
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1766
Practice Address - Country:US
Practice Address - Phone:562-595-5421
Practice Address - Fax:562-426-2862
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-131355207RG0100X
CAA106054207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036131355Medicaid
IL036131355Medicaid