Provider Demographics
NPI:1275843286
Name:SIMAN, WILFREDO SANTILLAN (ENGINEER)
Entity Type:Individual
Prefix:MR
First Name:WILFREDO
Middle Name:SANTILLAN
Last Name:SIMAN
Suffix:
Gender:M
Credentials:ENGINEER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14723 ALBERTA LN
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0675
Mailing Address - Country:US
Mailing Address - Phone:951-440-6049
Mailing Address - Fax:909-899-6330
Practice Address - Street 1:14723 ALBERTA LN
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-0675
Practice Address - Country:US
Practice Address - Phone:951-440-6049
Practice Address - Fax:909-899-6334
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-12
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)