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General NPI Number Information
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NPI Number | 1700022894
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Entity Type | Individual
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Provider Name | SHELLEY SANTOS CANLAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2008
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 2212 E 4TH ST
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City | SANTA ANA
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State | CA
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Zip | 92705-3870
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Country | US
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Telephone | 714-571-7700
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Fax | 714-571-7702
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Provider Business Mailing Address
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Address Line | 2212 E 4TH ST STE 103
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City | SANTA ANA
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State | CA
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Zip | 92705-3871
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Country | US
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Telephone | 714-571-7700
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Fax | 714-571-7702
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A106335
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A106335
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License Number State | CA
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