Provider Demographics
NPI:1932316494
Name:SANTOS, NELSON (DC)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W HIGH ST
Mailing Address - Street 2:# 748
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-1113
Mailing Address - Country:US
Mailing Address - Phone:805-531-1188
Mailing Address - Fax:
Practice Address - Street 1:530 NEW LOS ANGELES AVE
Practice Address - Street 2:STE 210
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-2089
Practice Address - Country:US
Practice Address - Phone:805-531-1188
Practice Address - Fax:805-531-1112
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor