Individual
ED SANTOS JESALVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2659 TOWNSGATE RD, SUITE 209, WESTLAKE VILLAGE, CA 91361-2710
(805) 374-1120
(805) 374-1124
Mailing address
2659 TOWNSGATE RD, SUITE 209, WESTLAKE VILLAGE, CA 91361-2710
(805) 374-1120
(805) 374-1124
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G058063
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZER60515
EMC PROVIDER NUMBER
AR
Enumeration date
02/03/2007
Last updated
11/10/2010
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