Basic Information
| Provider Information | |||||||||
| NPI: | 1821139056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLGUIN | ||||||||
| FirstName: | SANTIAGA | ||||||||
| MiddleName: | ADELINA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21520 PIONEER BLVD | ||||||||
| Address2: | SUITE #110 | ||||||||
| City: | HAWAIIAN GARDENS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907162603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628653644 | ||||||||
| FaxNumber: | 5628655244 | ||||||||
| Practice Location | |||||||||
| Address1: | 21520 SO PIONEER BLVD. | ||||||||
| Address2: | SUITE # 110 | ||||||||
| City: | HAWAIIAN GARDENS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907162603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628653644 | ||||||||
| FaxNumber: | 5628655244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246YC3302X | CA | Y | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Health Info | Coding Specialist, Physician Office Based |
No ID Information.