Organization
PACIFIC NEPHROLOGY GROUP A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALAM ISHAK MD (OWNER)
(619) 219-1161
Entity
Organization
Contact information
Practice address
182 INDUSTRIAL RD, GLEN ROCK, PA 17327-8626
(717) 235-9352
(717) 235-4024
Mailing address
995 GATEWAY CENTER WAY, SUITE 207, SAN DIEGO, CA 92102-4500
(619) 219-1161
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
03/22/2010
Last updated
05/28/2010
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