Healthcare Provider Details

I. General information

NPI: 1073527875
Provider Name (Legal Business Name): WILLIAM JAY EDELSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 WALNUT AVE
CARPINTERIA CA
93013-2028
US

IV. Provider business mailing address

300 N SAN ANTONIO RD
SANTA BARBARA CA
93110-1316
US

V. Phone/Fax

Practice location:
  • Phone: 805-560-1050
  • Fax: 805-560-1051
Mailing address:
  • Phone: 805-681-5461
  • Fax: 805-681-5200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC39503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: