Provider Demographics
NPI:1245435189
Name:SANTOS A. UY, JR MD INC.
Entity type:Organization
Organization Name:SANTOS A. UY, JR MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTOS
Authorized Official - Middle Name:ANIZAGA
Authorized Official - Last Name:UY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:213-484-1005
Mailing Address - Street 1:1300 N VERMONT AVE STE 907
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6094
Mailing Address - Country:US
Mailing Address - Phone:213-484-1005
Mailing Address - Fax:323-522-3618
Practice Address - Street 1:711 N. AL VARADO ST. #103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026
Practice Address - Country:US
Practice Address - Phone:213-484-1005
Practice Address - Fax:213-484-2053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A26898Medicare UPIN
CAA32697Medicare ID - Type Unspecified