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General NPI Number Information
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NPI Number | 1801441407
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Entity Type | Individual
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Provider Name | ELIDA SANTANA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 502 EUCLID AVE STE 304
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City | NATIONAL CITY
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State | CA
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Zip | 91950-8900
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Country | US
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Telephone | 619-477-0084
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Fax | 619-477-2066
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Provider Business Mailing Address
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Address Line | 2440 BANCROFT DR
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City | SPRING VALLEY
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State | CA
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Zip | 91977-3306
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Country | US
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Telephone | 619-368-3151
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 95-12407
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 95012407
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License Number State | CA
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