Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PAULUS SANTOSO MD A PROFESSIONAL CORPORATION
Active
Organization
PAULUS SANTOSO MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULUS LIEM SANTOSO M.D. (CEO)
(951) 530-8989
Entity
Organization
Contact information
Practice address
6969 BROCKTON AVE, SUITE A-B, RIVERSIDE, CA 92506-3809
(951) 530-8989
(951) 530-8877
Mailing address
6969 BROCKTON AVE, SUITE A-B, RIVERSIDE, CA 92506-3809
(951) 530-8989
(951) 530-8877
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
A85478
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A854780
MEDICARE
CA
05
—
00A854780
—
CA
Enumeration date
11/12/2009
Last updated
03/04/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers