Provider Demographics
NPI:1487051132
Name:SALEM, AMGAD (ARDMS,RVT,RDCS,NT)
Entity type:Individual
Prefix:
First Name:AMGAD
Middle Name:
Last Name:SALEM
Suffix:
Gender:M
Credentials:ARDMS,RVT,RDCS,NT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12092 MOVIUS DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-2930
Mailing Address - Country:US
Mailing Address - Phone:714-595-9012
Mailing Address - Fax:
Practice Address - Street 1:12092 MOVIUS DR
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-2930
Practice Address - Country:US
Practice Address - Phone:714-595-9012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography