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General NPI Number Information
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NPI Number | 1194461129
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Entity Type | Organization
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Legal Business Name | SANTO NINO HEALTH CENTER
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 14427 CHASE ST STE 100
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City | PANORAMA CITY
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State | CA
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Zip | 91402-3020
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Country | US
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Telephone | 818-830-7751
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Fax | 818-891-7892
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Provider Business Mailing Address
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Address Line | 14427 CHASE ST STE 100
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City | PANORAMA CITY
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State | CA
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Zip | 91402-3020
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Country | US
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Telephone | 818-830-7751
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Fax | 818-891-7892
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Authorized Official
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Title or Position | CEO
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Name | DR. GLENN MARSHAK
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Credential | MD
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Telephone | 818-830-7751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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