Healthcare Provider Details

I. General information

NPI: 1598782336
Provider Name (Legal Business Name): SALEH ADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/20/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE RM S-672
SAN FRANCISCO CA
94143-2205
US

IV. Provider business mailing address

513 PARNASSUS AVE ROOM S-672
SAN FRANCISCO CA
94143-2205
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-8542
  • Fax: 415-353-2811
Mailing address:
  • Phone: 415-514-8542
  • Fax: 415-353-2811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA52361
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberA52361
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: