Provider Demographics
NPI:1598782336
Name:ADI, SALEH (MD)
Entity type:Individual
Prefix:
First Name:SALEH
Middle Name:
Last Name:ADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 PARNASSUS AVE
Mailing Address - Street 2:ROOM S-672
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2205
Mailing Address - Country:US
Mailing Address - Phone:415-514-8542
Mailing Address - Fax:415-353-2811
Practice Address - Street 1:513 PARNASSUS AVE RM S-672
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2205
Practice Address - Country:US
Practice Address - Phone:415-514-8542
Practice Address - Fax:415-353-2811
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52361208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A523610Medicaid
CA00A523610Medicaid
CA00A523611Medicare ID - Type Unspecified