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NPI Code Detail

MEDICARE: DR. VINCENT M SANTORO MD

MEDICARE: DR. VINCENT M SANTORO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianMD00025701WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12356SAOTHERWAREGENCE BLUE SHIELD
22356SAOTHERREGENCE
30204542OTHERWAWA STATE LABOR & INDUST
40204542OTHERL & I

General Provider Information

NPI Number : 1942250535
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINCENT M SANTORO MD
Provider Business Mailing Address
First Line : 901 BOREN AVE
Second Line : #800
City : SEATTLE
State : WA
Zip : 98104-3534
Country : US
Telephone Number : 206-323-1900
Fax Number : 206-323-6868
Provider Business Practice Location Address
First Line : 12333 NE 130TH LANE
Second Line : #400
City : KIRKLAND
State : WA
Zip : 98034-7467
Country : US
Telephone Number : 206-323-1900
Fax Number : 206-323-6868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 11/04/2010

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Directions to “ DR. VINCENT M SANTORO MD” Practice Location

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