Organization Active NPI

Eduardo Santos Uy MD Inc

  • General Practice Physician
  • Fontana, CA
National Provider Identifier
1629257191
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EDUARDO SANTOS UY MD INC
Practice address
9717 Sierra Ave
Fontana, CA 92335-6716
Phone
(909) 822-3400
Fax
(909) 886-8881
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eduardo Santos Uy, M.D.
Title
President
Phone
(909) 886-8888

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

9717 Sierra Ave
Fontana, CA 92335-6716

Mailing address

9717 Sierra Ave
Fontana, CA 92335-6716
Phone (909) 822-3400

Other identifiers 1

IdentifierTypeStateIssuer
00A530160MedicaidCA

Other names 1

  • San Sebastian Family Medical Group, Inc. Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1014373Eduardo Santos Uy MD Inc9717 Sierra Avenue, Fontana, CA 92335Certificate of waiverJul 1, 2027

National Provider Directory

National Provider Directory

Locations

9717 Sierra Ave
Fontana, CA 92335
Phone (909) 822-3400

595 W Highland Ave
Sn Bernrdno, CA 92405
Phone (909) 882-3358

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1629257191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9717 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356716",
            "telephone_number": "909-822-3400",
            "fax_number": "909-886-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9717 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356716",
            "telephone_number": "909-822-3400",
            "fax_number": "909-886-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUARDO SANTOS UY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "UY",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "SANTOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-886-8888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A530160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Sebastian Family Medical Group, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.