MEDICARE: ELEANOR SANTIAGO 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
1	207R00000X	Internal Medicine Physician	A30385	CA
2	207RP1001X	Pulmonary Disease Physician	A30385	CA

General Provider Information

NPI Number	:	1922014877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELEANOR SANTIAGO MD

Provider Business Mailing Address
First Line	:	11755 VICTORY BLVD
Second Line	:	SUITE 206
City	:	N HOLLYWOOD
State	:	CA
Zip	:	91606-3423
Country	:	US
Telephone Number	:	818-762-9883
Fax Number	:	818-762-3237

Provider Business Practice Location Address
First Line	:	11755 VICTORY BLVD
Second Line	:	SUITE 206
City	:	N HOLLYWOOD
State	:	CA
Zip	:	91606-3423
Country	:	US
Telephone Number	:	818-762-9883
Fax Number	:	818-762-3237

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	06/28/2010

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Directions to “ ELEANOR SANTIAGO MD” Practice Location

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