Healthcare Provider Details

I. General information

NPI: 1083687891
Provider Name (Legal Business Name): JOSEPH A. DESANTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8780 WARNER AVE STE 11
FOUNTAIN VALLEY CA
92708-3210
US

IV. Provider business mailing address

8780 WARNER AVE STE 11
FOUNTAIN VALLEY CA
92708-3210
US

V. Phone/Fax

Practice location:
  • Phone: 949-432-0918
  • Fax: 949-209-2001
Mailing address:
  • Phone: 949-432-0918
  • Fax: 949-209-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG081151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: