Provider Demographics
NPI:1871655647
Name:ANTONE F SALEL, MD, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ANTONE F SALEL, MD, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONE
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:SALEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACC
Authorized Official - Phone:760-436-8085
Mailing Address - Street 1:PO BOX 1369
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-7369
Mailing Address - Country:US
Mailing Address - Phone:760-436-8085
Mailing Address - Fax:
Practice Address - Street 1:320 SANTA FE DR
Practice Address - Street 2:SUITE 211
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5138
Practice Address - Country:US
Practice Address - Phone:760-436-8085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG15832207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G158321Medicaid
CAWG15832FMedicare ID - Type Unspecified
CA00G158321Medicaid