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Organization
SANTANIELLO ORTHOPAEDIC MEDICAL CORPORATION
Active
Organization
SANTANIELLO ORTHOPAEDIC MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D SANTANIELLO M.D. (PRESIDENT)
(909) 982-4233
Entity
Organization
Contact information
Practice address
1238 E ARROW HWY, UPLAND, CA 91786-4951
(909) 982-4233
(909) 985-1103
Mailing address
1238 E. ARROW HWY., UPLAND, CA 91786-4910
(909) 982-4233
(909) 985-1103
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G21403
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G214031
MEDICARE INDIVIDUAL PTAN
CA
01
—
1124120696
JOHN SANTANIELLO (NPI)
CA
01
—
1265651608
SANTANIELLO ORTHO (NPI)
CA
01
—
G214030
LICENSE
CA
Enumeration date
04/24/2007
Last updated
04/09/2008
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