Provider Demographics
NPI:1013241165
Name:SANTAN HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:SANTAN HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KHUMALO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-398-3638
Mailing Address - Street 1:2181 E PECOS RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6140
Mailing Address - Country:US
Mailing Address - Phone:480-398-3638
Mailing Address - Fax:480-398-3643
Practice Address - Street 1:2982 E LOWELL AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1403
Practice Address - Country:US
Practice Address - Phone:480-238-7621
Practice Address - Fax:620-647-4819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ149317Medicare UPIN