Provider Demographics
NPI:1942473202
Name:KNELER, EDUARDO SANTIAGO (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:SANTIAGO
Last Name:KNELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 SAGUARE TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-6968
Mailing Address - Country:US
Mailing Address - Phone:510-490-3965
Mailing Address - Fax:
Practice Address - Street 1:1175 SAGUARE TER
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-6968
Practice Address - Country:US
Practice Address - Phone:510-490-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29553207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology