Provider Demographics
NPI:1770896599
Name:SANTOS, MA CLARISSE TOLEDO (MD)
Entity type:Individual
Prefix:DR
First Name:MA CLARISSE
Middle Name:TOLEDO
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MA CLARISSE
Other - Middle Name:MANRIQUE
Other - Last Name:TOLEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1585 KAPIOLANI BLVD 1800
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4500
Mailing Address - Country:US
Mailing Address - Phone:808-941-3363
Mailing Address - Fax:808-949-0483
Practice Address - Street 1:2226 LILIHA ST
Practice Address - Street 2:SUITE 306
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1600
Practice Address - Country:US
Practice Address - Phone:808-531-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18034207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology