Provider Demographics
NPI:1851691810
Name:DE LOS SANTOS, NORMAN S (RPH)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:S
Last Name:DE LOS SANTOS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 MING AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1318
Mailing Address - Country:US
Mailing Address - Phone:661-663-0598
Mailing Address - Fax:661-663-7282
Practice Address - Street 1:9000 MING AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-1318
Practice Address - Country:US
Practice Address - Phone:661-663-0598
Practice Address - Fax:661-663-7282
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist