MEDICARE: DR. ROBERT WILLIAM POULIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	G59821	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ56020Z	OTHER		BLUE SHIELD
2	G59821	OTHER	CA	MEDICAL LISCENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457461204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT WILLIAM POULIN M.D.

Provider Business Mailing Address
First Line	:	515 E MICHELTORENA ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-2257
Country	:	US
Telephone Number	:	805-963-4272
Fax Number	:	805-964-6617

Provider Business Practice Location Address
First Line	:	515 E MICHELTORENA ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-2257
Country	:	US
Telephone Number	:	805-963-4272
Fax Number	:	805-563-0883

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/11/2025

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