Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1013100965 |
---|---|
Provider Name | Daniel Santos |
First Address | Woodland, CA 95695-3125 |
Second Address | Woodland, CA 95695-3125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 23/08/2007 |