Individual
DR. NICHOLAS NELSON DESANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2306 6TH AVE, SAN DIEGO, CA 92101-1643
(619) 239-3286
(619) 239-0172
Mailing address
2306 6TH AVE, SAN DIEGO, CA 92101-1643
(619) 239-3286
(619) 239-0172
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E2474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E24740
BLUE CROSS
CA
05
—
000E24741
—
CA
Enumeration date
06/21/2005
Last updated
06/07/2013
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