| Doctor Name: | MICHELLE DOMINIQUE DE SANTO |
| NPI Number: | 1104194299 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 20A12005 |
| Business Practice Address: | 1001 S Garfield Ave Alhambra, CA - 918014772 |
| Business Phone Number: | 8187884513 |
| Business Fax Number: | |
| Mailing Address: | 1001 S Garfield Ave, ALHAMBRA |
| State: | CA |
| Postal Code: | 918014772 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2011 |
| NPI Last Update Date: | 12/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20A12005 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |