Basic Information
| Provider Information | |||||||||
| NPI: | 1003806324 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANTOS ONODA | ||||||||
| FirstName: | KIYOMI | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10730 | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007320730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878363288 | ||||||||
| FaxNumber: | 7878363288 | ||||||||
| Practice Location | |||||||||
| Address1: | 602 CALLE JOSE V RODRIGUEZ | ||||||||
| Address2: | |||||||||
| City: | PENUELAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006241807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878363288 | ||||||||
| FaxNumber: | 8666262798 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2005 | ||||||||
| LastUpdateDate: | 08/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 8100 | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.