Individual
MARCELLA SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(415) 999-5191
Mailing address
67 SKYVIEW WAY, SAN FRANCISCO, CA 94131-1248
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007744
IL
Other
Enumeration date
03/20/2020
Last updated
03/03/2021
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