Individual
DIEGO ULISES SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4411 E KINGS CANYON RD STE 319, FRESNO, CA 93702-3604
(559) 600-2382
Mailing address
3433 W SHAW AVE STE 107, FRESNO, CA 93711-3229
(559) 558-4051
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
701904
CA
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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