Provider Demographics
NPI:1922191733
Name:KRISTIN J. SANTANGELO, MD, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KRISTIN J. SANTANGELO, MD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISITN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SANTANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-371-3770
Mailing Address - Street 1:415 ROLLING OAKS DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1033
Mailing Address - Country:US
Mailing Address - Phone:805-371-3770
Mailing Address - Fax:805-371-4714
Practice Address - Street 1:415 ROLLING OAKS DR
Practice Address - Street 2:SUITE 260
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1033
Practice Address - Country:US
Practice Address - Phone:805-371-3770
Practice Address - Fax:805-371-4714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty