Organization Active NPI

Elizabeth Salada MD a Medical Corporation

  • Internal Medicine Physician
  • Poway, CA
National Provider Identifier
1619154804
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G82274 Issued in CA
Legal business name
ELIZABETH SALADA MD A MEDICAL CORPORATION
Practice address
15611 Pomerado Rd Ste 520
Poway, CA 92064-2437
Phone
(858) 312-5492
Fax
(858) 312-6421
NPI assigned
Jan 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
Elizabeth A Salada, M.D,NPI 1255396032
Title
President
Phone
(858) 312-5492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G82274 CA Primary

Addresses

Primary practice location

15611 Pomerado Rd Ste 520
Poway, CA 92064-2437

Mailing address

15611 Pomerado Rd Ste 520
Poway, CA 92064-2437
Phone (858) 312-5492

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elizabethsalada@salel.allscriptsdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080418000352 CA Part B Supplier - Clinic/Group Practice 5496833279 Receives reassigned benefits from 5 practitioners
Practice locations: Poway, CA

National Provider Directory

National Provider Directory

Locations

15611 Pomerado Rd
Ste 520
Poway, CA 92064
Phone (858) 312-5492

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1619154804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 POMERADO RD STE 520",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642437",
            "telephone_number": "858-312-5492",
            "fax_number": "858-312-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 POMERADO RD STE 520",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642437",
            "telephone_number": "858-312-5492",
            "fax_number": "858-312-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH SALADA MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "SALADA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-312-5492",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G82274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabethsalada@salel.allscriptsdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "15611 Pomerado Rd Ste 520",
            "city": "Poway",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920642437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.