Provider Demographics
NPI:1891118048
Name:GREGORIO D. ABAD-SANTOS INC
Entity Type:Organization
Organization Name:GREGORIO D. ABAD-SANTOS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAD-SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:714-966-0860
Mailing Address - Street 1:11100 WARNER AVE
Mailing Address - Street 2:SUITE 352
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7506
Mailing Address - Country:US
Mailing Address - Phone:714-966-0860
Mailing Address - Fax:
Practice Address - Street 1:11100 WARNER AVE
Practice Address - Street 2:SUITE 352
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7506
Practice Address - Country:US
Practice Address - Phone:714-966-0860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42068208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty