Individual
DR. PAULUS L. SANTOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6969 BROCKTON AVE, STE. A-B, RIVERSIDE, CA 92506-3809
(951) 530-8989
(951) 530-8877
Mailing address
6969 BROCKTON AVE, STE. A-B, RIVERSIDE, CA 92506-3809
(951) 530-8989
(951) 530-8877
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
A85478
CA
207VX0000X
Obstetrics Physician
Primary
A85478
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A854780
—
CA
Enumeration date
07/12/2005
Last updated
03/04/2016
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