Healthcare Provider Details

I. General information

NPI: 1699015529
Provider Name (Legal Business Name): ANDREW SALEH MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 ROSECRANS ST STE A
SAN DIEGO CA
92106-2676
US

IV. Provider business mailing address

3875 SACRAMENTO DR
LA MESA CA
91941-6887
US

V. Phone/Fax

Practice location:
  • Phone: 619-223-2698
  • Fax:
Mailing address:
  • Phone: 310-925-1826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberA135553
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberD0077579
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: