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Michelle Dominique De Santo, DO
General Practice Physician in Alhambra, California
NPI 1104194299

Michelle Dominique De Santo is a General Practice Physician based in Alhambra, CA. Michelle Dominique De Santo practices in Alhambra, CA and has the professional credentials of DO. The NPI Number for Michelle Dominique De Santo is 1104194299 and holds a License No. 20A12005 (California).

The current practice location address for Michelle Dominique De Santo is 1001 S Garfield Ave, Alhambra, CA and can be reached out via phone at 818-788-4513.

Location: 1001 S Garfield Ave, Alhambra, CA, 91801-4772
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104194299
Provider Name
Michelle Dominique De Santo
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
1001 S Garfield Ave, Alhambra, CA, 91801-4772
Phone Number
818-788-4513
Fax Number
Provider Enumeration Date
12/05/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
20A12005 01 CA OSTEOPATHIC MEDICAL BOARD OF CALIFORNIA
institution
Provider Business Practice Location Address Details
Address
1001 S Garfield Ave
City
Alhambra
State
California
Zip
91801-4772
Phone Number
818-788-4513
Fax Number
person
Provider Business Mailing Address Details
Address
1001 S Garfield Ave
City
Alhambra
State
California
Zip
91801-4772
Phone Number
818-788-4513
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
20A12005 (California)
Definition
Definition to come...
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