Healthcare Provider Details

I. General information

NPI: 1740520667
Provider Name (Legal Business Name): SPINE AND PAIN TREATMENT MEDICAL CENTER OF SANTA BARBARA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 02/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5771 N FRESNO ST SUITE 101
FRESNO CA
93710-6091
US

IV. Provider business mailing address

135 CARMEN LN
SANTA MARIA CA
93458-7729
US

V. Phone/Fax

Practice location:
  • Phone: 805-928-7361
  • Fax: 805-928-5742
Mailing address:
  • Phone: 805-928-7361
  • Fax: 805-928-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANCIS P LAGATTUTA I
Title or Position: OWNER
Credential: MD
Phone: 805-928-7361