Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 28519 | MD |
Y | 213ES0000X | Sports Medicine | 28519 | MD |
NPI | 1164197844 |
---|---|
Provider Name | Robert James Santana |
First Address | Fullerton, CA 92831-4313 |
Second Address | Nottingham, MD 21236-9283 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2021 |
Last Update Date | 13/08/2021 |