Healthcare Provider Details

I. General information

NPI: 1942399647
Provider Name (Legal Business Name): CHARITY OSAIS SANTIAGO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 34TH ST STE 100&20
BAKERSFIELD CA
93301-2305
US

IV. Provider business mailing address

625 34TH ST STE 100&20
BAKERSFIELD CA
93301-2305
US

V. Phone/Fax

Practice location:
  • Phone: 833-678-2781
  • Fax: 661-368-0618
Mailing address:
  • Phone: 833-678-2781
  • Fax: 661-368-0618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA83720
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: