Provider Demographics
NPI:1528135365
Name:ESMAIL, SALINA (NP)
Entity type:Individual
Prefix:
First Name:SALINA
Middle Name:
Last Name:ESMAIL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 BRIDGEWATER LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1435
Mailing Address - Country:US
Mailing Address - Phone:909-936-4455
Mailing Address - Fax:909-595-3334
Practice Address - Street 1:844 BRIDGEWATER LN
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-1435
Practice Address - Country:US
Practice Address - Phone:909-936-4455
Practice Address - Fax:909-595-3334
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN370840363L00000X
CANP 9714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q03129Medicare UPIN