Healthcare Provider Details

I. General information

NPI: 1518126176
Provider Name (Legal Business Name): JOS SANTZ II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2008
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2693 E. WASHINGTON BLVD
PASADENA CA
91107
US

IV. Provider business mailing address

PO BOX 1305
ROSEMEAD CA
91770
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-8600
  • Fax:
Mailing address:
  • Phone: 626-673-0725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA112868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: