Provider Demographics
NPI:1962413229
Name:ARTACHO, ISABELO SANTOS (MD)
Entity type:Individual
Prefix:DR
First Name:ISABELO
Middle Name:SANTOS
Last Name:ARTACHO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6323 N FRESNO STREET
Mailing Address - Street 2:STE # 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5282
Mailing Address - Country:US
Mailing Address - Phone:559-227-7141
Mailing Address - Fax:559-227-7130
Practice Address - Street 1:6323 N FRESNO STREET
Practice Address - Street 2:STE # 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5282
Practice Address - Country:US
Practice Address - Phone:559-227-7141
Practice Address - Fax:559-227-7130
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2015-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA461292084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E30288Medicare UPIN
E30288Medicare UPIN