Individual provider Active NPI

Egisto Salerno, MD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1053423764
Registry record updated Jul 8, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective May 20, 2021.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A37903 Issued in CA
Practice address
2850 6TH Ave
San Diego, CA 92103-6308
Phone
(619) 422-2555
Fax
(619) 422-2223
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A37903 CA Primary

Addresses

Primary practice location

2850 6TH Ave
San Diego, CA 92103-6308

Mailing address

5125 Jumilla St
San Diego, CA 92124-1503
Phone (858) 268-3989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37903CAMDPharmacist
A37903CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miles V Stanich, MD Inc Internal Medicine Past Accepting new patients
Jerry Rand Apmc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053423764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 JUMILLA ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921241503",
            "telephone_number": "858-268-3989",
            "fax_number": "619-422-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 6TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036308",
            "telephone_number": "619-422-2555",
            "fax_number": "619-422-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALERNO",
        "first_name": "EGISTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A37903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.