Provider Demographics
NPI:1629185798
Name:SANTOS, PIA SIOSON (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:PIA
Middle Name:SIOSON
Last Name:SANTOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18TH MEDCOM
Mailing Address - Street 2:ATTN: DCCS-QM (CREDETIALS)
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-0054
Mailing Address - Country:KR
Mailing Address - Phone:0118227-916-6027
Mailing Address - Fax:011827-917-8110
Practice Address - Street 1:HHC BSTB
Practice Address - Street 2:UNIT 15046
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96224
Practice Address - Country:KR
Practice Address - Phone:0118223-147-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1070757363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant