Provider Demographics
NPI:1700907797
Name:SANTO, CARLOS (NMD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:SANTO
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8880 E VIA LINDA STE 107
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5412
Mailing Address - Country:US
Mailing Address - Phone:480-363-2501
Mailing Address - Fax:
Practice Address - Street 1:8880 E VIA LINDA STE 107
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5412
Practice Address - Country:US
Practice Address - Phone:480-363-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ97-517207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine