Healthcare Provider Details
I. General information
NPI: 1013241165
Provider Name (Legal Business Name): SANTAN HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2009
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2982 E LOWELL AVE
GILBERT AZ
85295-1403
US
IV. Provider business mailing address
2181 E PECOS RD SUITE 1
CHANDLER AZ
85225-6140
US
V. Phone/Fax
- Phone: 480-238-7621
- Fax: 620-647-4819
- Phone: 480-398-3638
- Fax: 480-398-3643
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MATTHEW
KHUMALO
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 480-398-3638