Provider Demographics
NPI:1861526451
Name:SALEH, JAHANDAR REZA (MD)
Entity type:Individual
Prefix:DR
First Name:JAHANDAR
Middle Name:REZA
Last Name:SALEH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18350 ROSCOE BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4109
Mailing Address - Country:US
Mailing Address - Phone:818-678-4900
Mailing Address - Fax:
Practice Address - Street 1:18350 ROSCOE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4109
Practice Address - Country:US
Practice Address - Phone:818-678-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA74385207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA74385AMedicare PIN