Basic Information
| Provider Information | |||||||||
| NPI: | 1093138547 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALAMAT | ||||||||
| FirstName: | AREZOU | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | NICHOL HL | ||||||||
| Address2: | A909 | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923500001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9518472377 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1908 BUSINESS CENTER DR | ||||||||
| Address2: | SUITE # 220 | ||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924083436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098905930 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2014 | ||||||||
| LastUpdateDate: | 02/03/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | 6822 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.