Provider Demographics
NPI:1326034521
Name:SANTOYO, KEITH (MD)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:
Last Name:SANTOYO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5309
Mailing Address - Country:US
Mailing Address - Phone:805-739-3759
Mailing Address - Fax:805-739-3989
Practice Address - Street 1:1400E CHURCH STREET
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:805-739-3759
Practice Address - Fax:805-739-3989
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70450207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G704500Medicaid
CAF67886Medicare UPIN
CAWG70450BMedicare PIN