| NPI | 1770685612 |
|---|---|
| Doing Business As | SANTO NINO MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | GLENN A MARSHAK President / Owner 818-830-7751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A44687) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PA15625) |
| 207Q00000X Family Medicine (Licence: CA C50675) | |
| 208D00000X General Practice (Licence: CA G080659) | |
| 363A00000X Physician Assistant (Licence: CA PA21838) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2023-02-14 |