Provider Demographics
NPI:1689199192
Name:DELASANTOS, CAMERON JAMES (DPT)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:JAMES
Last Name:DELASANTOS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 G ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6808
Mailing Address - Country:US
Mailing Address - Phone:619-238-4318
Mailing Address - Fax:619-238-4320
Practice Address - Street 1:295 G ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-6808
Practice Address - Country:US
Practice Address - Phone:192-384-3186
Practice Address - Fax:619-238-4320
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist