MEDICARE: BRIAN SANTINI MD A PROFESSIONAL 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	A83094	CA

General Provider Information

NPI Number	:	1356650741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN SANTINI MD A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	8160 QUARTZ ST
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93004-4038
Country	:	US
Telephone Number	:	805-265-6099
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 LAS POSAS RD STE 205
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1506
Country	:	US
Telephone Number	:	805-258-6137
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRIAN SANTINI
Credential	:
Telephone Number	:	805-258-6137

Provider Enumeration Date	:	10/01/2010
Last Update Date	:	10/01/2010

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