Active NPI
Carmen Castillo Santos, M.D.
- Anesthesiology Physician
- Victorville, CA
National Provider Identifier
1093723215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- C42862
- Practice address
- 15248 11TH St
Victorville, CA 92395-3704 - Phone
- (760) 843-6075
- Fax
- (760) 843-6050
- NPI assigned
- Aug 3, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | C42862 | CA | Primary |
Addresses
Primary practice location
15248 11TH St
Victorville, CA 92395-3704
Mailing address
500 S Main St
1210
Orange, CA 92868-4507
Phone (714) 560-1580
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C428620 | Other | CA | BLUE SHIELD |
| 00C428620 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C42862 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093723215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S MAIN ST",
"address_2": "1210",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684507",
"telephone_number": "714-560-1580",
"fax_number": "714-560-1585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15248 11TH ST",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923953704",
"telephone_number": "760-843-6075",
"fax_number": "760-843-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS",
"first_name": "CARMEN",
"middle_name": "CASTILLO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "C42862",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00C428620",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C428620",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.