Provider Demographics
NPI:1154062560
Name:KALAN, SANTOSH
Entity Type:Individual
Prefix:
First Name:SANTOSH
Middle Name:
Last Name:KALAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14002 E 21ST ST STE 1130
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-1408
Mailing Address - Country:US
Mailing Address - Phone:918-439-1500
Mailing Address - Fax:
Practice Address - Street 1:14002 E 21ST ST STE 1130
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134-1408
Practice Address - Country:US
Practice Address - Phone:918-439-1500
Practice Address - Fax:918-439-1199
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program