Healthcare Provider Details

I. General information

NPI: 1972664183
Provider Name (Legal Business Name): SAL C SANTANGELO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N ROSE AVE STE 470
OXNARD CA
93030-3790
US

IV. Provider business mailing address

35 LA PATERA CT
CAMARILLO CA
93010-8412
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-0707
  • Fax: 805-983-0334
Mailing address:
  • Phone: 805-482-6400
  • Fax: 805-482-3068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG33564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: