Individual
EDDY DE LOS SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1540W VAN BUREN ST, PHOENIX, AZ 85007-2414
(480) 784-1514
(480) 736-4939
Mailing address
618S MADISON DR, TEMPE, AZ 85281-7248
(480) 784-1514
(480) 736-4939
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33474
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
947898
—
AZ
Enumeration date
11/02/2006
Last updated
10/12/2015
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