Provider Demographics
NPI:1497216659
Name:DEL MAR, JOSE MIGUEL SANTINO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSE MIGUEL SANTINO
Middle Name:
Last Name:DEL MAR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 N MATHILDA AVE APT F107
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4259
Mailing Address - Country:US
Mailing Address - Phone:575-390-7240
Mailing Address - Fax:
Practice Address - Street 1:450 N MATHILDA AVE APT F107
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4259
Practice Address - Country:US
Practice Address - Phone:575-390-7240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist