Healthcare Provider Details

I. General information

NPI: 1942473202
Provider Name (Legal Business Name): EDUARDO SANTIAGO KNELER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 HIGH LN
REDONDO BEACH CA
90278-5107
US

IV. Provider business mailing address

715 HIGH LN
REDONDO BEACH CA
90278-5107
US

V. Phone/Fax

Practice location:
  • Phone: 510-506-0747
  • Fax: 256-488-4882
Mailing address:
  • Phone: 510-506-0747
  • Fax: 256-488-4882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA29553
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: