Provider Demographics
NPI:1972646594
Name:SANTOS, GEANA B (MD)
Entity Type:Individual
Prefix:DR
First Name:GEANA
Middle Name:B
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JEANNA
Other - Middle Name:BUMATAY
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11258 EVERGREEN LOOP
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-8477
Mailing Address - Country:US
Mailing Address - Phone:323-868-1294
Mailing Address - Fax:
Practice Address - Street 1:2055 KELLOGG AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3111
Practice Address - Country:US
Practice Address - Phone:866-984-7483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98101207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine