Santoso, Paulus L.

Santoso, Paulus L. is an individual health care provider with primary practice located at 6969 Brockton Ave Ste. A-B, Riverside CA 92506-3809. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Obstetrics is his primary health care specialty. Santoso, Paulus L. can be contacted via phone (951) 530-8989.

Contact Information

Primary practice address
6969 Brockton Ave Ste. A-B Riverside CA 92506-3809
Phone: (951) 530-8989
Fax: (951) 530-8877
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X A85478 California
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X A85478 California

Profile Details

NPI number 1154329373
LBN Legal business name Santoso, Paulus L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Mar 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154329373 NPPES
California MEDICAID 00A854780

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