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General NPI Number Information
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NPI Number | 1538755590
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Entity Type | Individual
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Provider Name | AMANDA SAHAR SANTOS PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/14/2020
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 9250 E COSTILLA AVE STE 540
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80112-3648
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Country | US
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Telephone | 720-644-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 5441 LYNX ST
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City | FREDERICK
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State | CO
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Zip | 80504-3408
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Country | US
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Telephone | 724-841-9560
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA.0006985
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License Number State | CO
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