Healthcare Provider Details

I. General information

NPI: 1427344142
Provider Name (Legal Business Name): CARTER KEITH ANDERSEN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1013 CASITAS PASS RD
CARPINTERIA CA
93013-2108
US

IV. Provider business mailing address

455 N HOPE AVE
SANTA BARBARA CA
93110-1573
US

V. Phone/Fax

Practice location:
  • Phone: 805-566-0306
  • Fax: 805-566-0316
Mailing address:
  • Phone: 805-451-0961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number14172
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: