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Individual

DR. AGNES C SANTOSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11241 SPENCERPORT WAY, SAN DIEGO, CA 92131-2912
(858) 549-9652
(858) 549-4941
Mailing address
11241 SPENCERPORT WAY, SAN DIEGO, CA 92131-2912
(858) 549-9652
(858) 549-4941

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A71735
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A717350
CA
Enumeration date
07/13/2006
Last updated
07/08/2007
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