Individual
SUSANNA SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Mailing address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
AP2631
MA
363AM0700X
Medical Physician Assistant
Primary
21556
CA
363AS0400X
Surgical Physician Assistant
AP2631
MA
Other
Enumeration date
10/15/2008
Last updated
11/03/2022
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