Organization
JEFFREY R DESANTIS DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY R DESANTIS DPM (OWNER)
(714) 771-4191
Entity
Organization
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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0791680001
DMERC
—
Enumeration date
10/05/2006
Last updated
08/22/2020
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