Provider Demographics
NPI:1245222470
Name:SANTOS, MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 34TH ST STE 100&200
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2305
Mailing Address - Country:US
Mailing Address - Phone:833-678-2781
Mailing Address - Fax:661-368-0618
Practice Address - Street 1:625 34TH ST STE 100&200
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2305
Practice Address - Country:US
Practice Address - Phone:833-678-2781
Practice Address - Fax:661-368-0618
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52275208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF99264Medicare UPIN