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Individual

DR. BOULES SALIB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
5411 ETIWANDA AVE # 200, TARZANA, CA 91356-3648
(424) 314-0270
Mailing address
19634 VENTURA BLVD, STE 321, TARZANA, CA 91356-2994
(310) 388-8788
(855) 667-6377

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
257623
NY
207R00000X
Internal Medicine Physician
25MA08661500
NJ
207R00000X
Internal Medicine Physician
Primary
A125934
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CB231329
MEDICARE PTAN
CA
Enumeration date
10/30/2008
Last updated
10/11/2022
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