Provider Demographics
NPI:1932208964
Name:SANTIAGO, VICENTE ALBANO III (MD)
Entity Type:Individual
Prefix:DR
First Name:VICENTE
Middle Name:ALBANO
Last Name:SANTIAGO
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2615 E CLINTON AVE
Mailing Address - Street 2:SEQUOIA CLINIC, VA CENTRAL CALIFORNIA
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-2223
Mailing Address - Country:US
Mailing Address - Phone:559-225-6100
Mailing Address - Fax:559-228-5377
Practice Address - Street 1:2615 E CLINTON AVE
Practice Address - Street 2:SEQUOIA CLINIC, VA CENTRAL CALIFORNIA
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-2223
Practice Address - Country:US
Practice Address - Phone:559-225-6100
Practice Address - Fax:559-228-5377
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2022-02-11
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Provider Licenses
StateLicense IDTaxonomies
CAA76609207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine