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Individual

JEFFREY R DESANTIS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1038 E CHAPMAN AVE, ORANGE, CA 92866-2111
(714) 771-4191
(714) 771-2731
Mailing address
1038 E CHAPMAN AVE, ORANGE, CA 92866-2111
(714) 771-4191
(714) 771-2731

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3758
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E37580
CA
Enumeration date
07/29/2005
Last updated
07/08/2007
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