Provider Demographics
NPI:1780772111
Name:SANTOS, AMADEU FEDERICO (MD)
Entity type:Individual
Prefix:DR
First Name:AMADEU
Middle Name:FEDERICO
Last Name:SANTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:2800 L ST
Practice Address - Street 2:SUITE 610
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5616
Practice Address - Country:US
Practice Address - Phone:916-733-8393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103322207UN0902X, 2085R0202X, 2085R0204X, 2085R0202X, 207UN0902X
NV13103207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI45146-020OtherDEPT. OF REGULATION AND L
NVP00764149OtherRAILROAD MEDICARE
TN45594OtherTN BOARD OF MEDICAL EXAMINERS
CA1780772111Medicaid
CAA103322OtherMEDICAL BOARD OF CALIFORNIA
NV1780772111Medicaid
NV13103OtherNEVADA STATE BOARD OF MEDICAL EXAMINERS
MN43787OtherPHYSICIAN AND SURGEON LIC
CA1780772111Medicaid
NVP00764149OtherRAILROAD MEDICARE