Provider Demographics
NPI:1982227625
Name:AL-SALEH, TARIQ (BCCP, APH, RPH, PACS)
Entity type:Individual
Prefix:
First Name:TARIQ
Middle Name:
Last Name:AL-SALEH
Suffix:
Gender:
Credentials:BCCP, APH, RPH, PACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 14TH ST APT 531
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7841
Mailing Address - Country:US
Mailing Address - Phone:786-445-2814
Mailing Address - Fax:619-367-0409
Practice Address - Street 1:505 N MOLLISON AVE STE 102
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-6159
Practice Address - Country:US
Practice Address - Phone:619-457-0545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH82332183500000X
CAB101005991835C0206X, 1835P0018X
CA110971835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist
No1835C0206XPharmacy Service ProvidersPharmacistCardiology
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A115530OtherTHE BLUE SHIELD OF CALIFORNIA (BSC)