Provider Demographics
NPI:1154516623
Name:SAUCEDO, SANTA RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:SANTA
Middle Name:RUTH
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8209 E HILLSDALE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-2440
Mailing Address - Country:US
Mailing Address - Phone:714-288-1007
Mailing Address - Fax:
Practice Address - Street 1:8209 E HILLSDALE DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-2440
Practice Address - Country:US
Practice Address - Phone:714-288-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
G79897174400000X
CAG079897208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist