Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA09669300 | NJ |
N | 111NI0900X | Internist | 25MA09669300 | NJ |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A168300 | CA |
N | 207RI0011X | Interventional Cardiology | A168300 | CA |
NPI | 1104187368 |
---|---|
Provider Name | Ahmed Seliem |
First Address | Loma Linda, CA 92354-2804 |
Second Address | Loma Linda, CA 92354-2804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 26/08/2020 |