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General NPI Number Information
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NPI Number | 1386119725
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Entity Type | Individual
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Provider Name | EUGENE SANTOS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 11/13/2019
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Provider Practice Location Address
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Address Line | 3600 LIME ST STE 516
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City | RIVERSIDE
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State | CA
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Zip | 92501-0944
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Country | US
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Telephone | 951-367-1060
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 LIME ST STE 516
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City | RIVERSIDE
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State | CA
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Zip | 92501-0944
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Country | US
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Telephone | 951-367-1060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95009668
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License Number State | CA
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