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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up