Healthcare Provider Details

I. General information

NPI: 1699669150
Provider Name (Legal Business Name): FRANKIE POGAN SANTOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 W WILLIAMS ST STE 1
LONG BEACH CA
90810-3617
US

IV. Provider business mailing address

10205 BUFORD AVE APT 26
INGLEWOOD CA
90304-3473
US

V. Phone/Fax

Practice location:
  • Phone: 562-388-8118
  • Fax:
Mailing address:
  • Phone: 310-686-1663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: