Antonio A De Salles, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

A51650 Issued in CA

Practice address

300 Medical Plaza
#200
Los Angeles, CA 90095-0001

Phone

(310) 825-5111

NPI assigned

Aug 10, 2006

Last updated

Jul 16, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1821009598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-825-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLAZA",
            "address_2": "#200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SALLES",
        "first_name": "ANTONIO",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A51650",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A51650",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A516500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Sachdeva De Peralta, RN, MSN, NP, CS
• Ivy Lee De Quiros, NURSE PRACTITIONER
• Andrew Bayani De Ramos, LCSW
• Melissa Gonzales De Ramos, LCSW
• Cristina De Ruiz, MSW
• Carlos De Santiago
• Miryam De Santiago
• Patricia De Santiago
• Sarah Rose De Santis
• Elena Lucia De Santo

• Neurological Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.