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NPI Code Detail

MEDICARE: JORGE SANTIBANEZ MD

MEDICARE: JORGE SANTIBANEZ MD
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
1207R00000XInternal Medicine PhysicianMD24602OR
2208M00000XHospitalist Physician13739NV
3208M00000XHospitalist Physician7746287-1205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568446672
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE SANTIBANEZ MD
Provider Business Mailing Address
First Line : PO BOX 3299
Second Line :
City : CARSON CITY
State : NV
Zip : 89702-3299
Country : US
Telephone Number : 775-222-0044
Fax Number : 888-700-0187
Provider Business Practice Location Address
First Line : 1600 MEDICAL PKWY
Second Line :
City : CARSON CITY
State : NV
Zip : 89703-4625
Country : US
Telephone Number : 775-445-8795
Fax Number : 775-445-5175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 05/30/2017

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