Healthcare Provider Details

I. General information

NPI: 1275161333
Provider Name (Legal Business Name): DANIELA SANTOS CANTU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 G RD
GRAND JUNCTION CO
81505-9641
US

IV. Provider business mailing address

4604 S SUGAR ROAD, UNIT 1028 UNIT 1028
EDINBURG TX
78539-1223
US

V. Phone/Fax

Practice location:
  • Phone: 970-262-0920
  • Fax: 970-257-6251
Mailing address:
  • Phone: 720-579-2014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDR.0072433
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: