Provider Demographics
NPI:1245235738
Name:SANTIESTEBAN, HECTOR LUIS (MEDICAL DOCTOR)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:LUIS
Last Name:SANTIESTEBAN
Suffix:
Gender:
Credentials:MEDICAL DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 SULLIVAN AVE RM 507
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2225
Mailing Address - Country:US
Mailing Address - Phone:415-573-4166
Mailing Address - Fax:650-745-7250
Practice Address - Street 1:1800 SULLIVAN AVE RM 507
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2225
Practice Address - Country:US
Practice Address - Phone:650-472-9667
Practice Address - Fax:650-745-7250
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG60085207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA53546Medicare UPIN
CA00G600850Medicare ID - Type Unspecified