Healthcare Provider Details

I. General information

NPI: 1841864972
Provider Name (Legal Business Name): RILEY SANTOS-READ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 W 23RD ST
LOS ANGELES CA
90007-2612
US

IV. Provider business mailing address

326 W 23RD ST
LOS ANGELES CA
90007-2612
US

V. Phone/Fax

Practice location:
  • Phone: 235-411-4113
  • Fax:
Mailing address:
  • Phone: 323-541-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA62846
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: