Provider Demographics
NPI:1699794230
Name:SALEL, ANTONE F (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONE
Middle Name:F
Last Name:SALEL
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: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:858-755-5728
Mailing Address - Fax:858-755-6971
Practice Address - Street 1:4553 NORTH LN
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-4133
Practice Address - Country:US
Practice Address - Phone:760-436-8085
Practice Address - Fax:858-755-6971
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG15832207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G158321Medicaid
CA00G158321Medicaid
CAWG15832FMedicare ID - Type Unspecified