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DR. PAULUS L. SANTOSO M.D. NPI 1154329373


NPI Information

NPI: 1154329373
Provider Name: DR. PAULUS L. SANTOSO, M.D.
Classification: Obstetrics & Gynecology - 207VX0000X
Entity Type: Individual

Specialization: Obstetrics

PECOS Registration: Yes

CLIA Number: 05D1107032

Address:
6969 BROCKTON AVE
STE. A-B
RIVERSIDE, CA
ZIP 92506
Phone: (951) 530-8989
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DR. Paulus L. Santoso, M.D. is an obstetrics obstetrics gynecology in Riverside, CA with 26 years of experience. The provider is a physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee DR. Paulus L. Santoso, M.D. NPI is 1154329373. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduation Year:1998

The provider's business location address is:

6969 BROCKTON AVE
STE. A-B
RIVERSIDE, CA
ZIP 92506-809
Phone: (951) 530-8989
Fax: (951) 530-8877

The NPI 1154329373 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D1107032 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/12/2005 and was last updated on 3/4/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyA85478CALIFORNIANo
2207VX0000XObstetrics & GynecologyObstetricsA85478CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H73276MEDICARE UPINCALIFORNIA
200A854780MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
300A854780MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.