Healthcare Provider Details

I. General information

NPI: 1730851007
Provider Name (Legal Business Name): RANEL TROY SANTOS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2510 FAIR OAKS BLVD APT 137
SACRAMENTO CA
95825-7649
US

V. Phone/Fax

Practice location:
  • Phone: 408-506-7644
  • Fax:
Mailing address:
  • Phone: 408-506-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number80807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: