MEDICARE: ONE SANTA FE CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	11227	NV

General Provider Information

NPI Number	:	1063600039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE SANTA FE CORPORATION

Provider Business Mailing Address
First Line	:	10087 CANYON HILLS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-7646
Country	:	US
Telephone Number	:	702-631-1119
Fax Number	:

Provider Business Practice Location Address
First Line	:	3680 E SUNSET RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-7235
Country	:	US
Telephone Number	:	702-631-1119
Fax Number	:	702-631-1119

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIA CARMINA R ARRASTIA
Credential	:	MD
Telephone Number	:	702-631-1119

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	10/04/2007

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Directions to “ONE SANTA FE CORPORATION ” Practice Location

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