Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | G58702 | CA |
NPI | 1053350231 |
---|---|
Provider Name | Mrs. Ann Kelley Salahuddin |
First Address | Ventura, CA 93003-7672 |
Second Address | Ventura, CA 93003-2840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 07/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G587020 | (05) | CA |
5628497 | NCPDP/NPDS (01) | CA |
830001988 | RAILROAD MEDICARE (01) | |
E04659 | (02) |