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General NPI Number Information
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NPI Number | 1720162563
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Entity Type | Organization
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Legal Business Name | EDWARD J. SANTORO MD., INC.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 703 N FULTON ST SUITE 202
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City | FRESNO
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State | CA
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Zip | 93728-3405
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Country | US
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Telephone | 559-237-1580
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Fax | 559-233-3381
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Provider Business Mailing Address
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Address Line | 703 N FULTON ST SUITE 202
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City | FRESNO
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State | CA
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Zip | 93728-3405
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Country | US
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Telephone | 559-237-1580
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Fax | 559-233-3381
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | EDWARD J SANTORO
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Credential | M.D.
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Telephone | 559-237-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A21184
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License Number State | CA
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