Individual
ALEXANDER CHARLES SALLOUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 BROADWAY STE 305, CHULA VISTA, CA 91911
(619) 567-7007
(619) 567-7775
Mailing address
1111 BROADWAY STE 305, CHULA VISTA, CA 91911-2700
(619) 567-7007
(619) 567-7775
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
A89300
CA
208600000X
Surgery Physician
A89300
CA
2086S0129X
Vascular Surgery Physician
Primary
A89300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124176151
—
CA
Enumeration date
01/08/2007
Last updated
09/30/2022
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