Provider Demographics
NPI:1770502411
Name:SEN, SANTOSH K (MD)
Entity Type:Individual
Prefix:DR
First Name:SANTOSH
Middle Name:K
Last Name:SEN
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 1:8337 TELEGRAPH RD
Mailing Address - Street 2:225
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-4909
Mailing Address - Country:US
Mailing Address - Phone:562-806-1335
Mailing Address - Fax:562-928-9534
Practice Address - Street 1:8337 TELEGRAPH RD
Practice Address - Street 2:225
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-4909
Practice Address - Country:US
Practice Address - Phone:562-806-1335
Practice Address - Fax:562-928-9534
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34186261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center