Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A93892 | CA |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A93982 | CA |
NPI | 1720262470 |
---|---|
Provider Name | Melanie Santos |
First Address | Fullerton, CA 92835-3614 |
Second Address | Fullerton, CA 92835-3614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2007 |
Last Update Date | 10/11/2021 |