Provider Demographics
NPI:1790812592
Name:FERRER, LUZ SANTIAGO (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:SANTIAGO
Last Name:FERRER
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 E 24TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-6716
Mailing Address - Country:US
Mailing Address - Phone:619-474-2933
Mailing Address - Fax:
Practice Address - Street 1:323 E 24TH ST APT 202
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-6716
Practice Address - Country:US
Practice Address - Phone:619-474-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA526140171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider