Healthcare Provider Details

I. General information

NPI: 1356340384
Provider Name (Legal Business Name): ROBERT THOMAS SANTOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5565 W LAS POSITAS BLVD SUITE #260
PLEASANTON CA
94588-4001
US

IV. Provider business mailing address

5565 W LAS POSITAS BLVD SUITE #260
PLEASANTON CA
94588-4001
US

V. Phone/Fax

Practice location:
  • Phone: 925-460-8478
  • Fax: 925-734-0517
Mailing address:
  • Phone: 925-460-8478
  • Fax: 925-734-0517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG40697
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: