Provider Demographics
NPI:1558449496
Name:SANTILLAN, ELVIRA CASTILLO (CRNFA)
Entity Type:Individual
Prefix:
First Name:ELVIRA
Middle Name:CASTILLO
Last Name:SANTILLAN
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 DIANA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-4413
Mailing Address - Country:US
Mailing Address - Phone:626-449-9159
Mailing Address - Fax:626-449-9159
Practice Address - Street 1:2740 DIANA ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4413
Practice Address - Country:US
Practice Address - Phone:626-449-9159
Practice Address - Fax:626-449-9159
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA274358364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative