Provider Demographics
NPI:1447448493
Name:YATOOMA, SALAM DAOUD (MD)
Entity type:Individual
Prefix:DR
First Name:SALAM
Middle Name:DAOUD
Last Name:YATOOMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SALAM
Other - Middle Name:DAOUD
Other - Last Name:PETROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5555 GROSSMONT CENTER DR
Mailing Address - Street 2:HOSPITALIST OFFICE
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3019
Mailing Address - Country:US
Mailing Address - Phone:619-740-6000
Mailing Address - Fax:619-740-4204
Practice Address - Street 1:5555 GROSSMONT CENTER DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3019
Practice Address - Country:US
Practice Address - Phone:619-937-6345
Practice Address - Fax:619-740-4204
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102344207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine