Healthcare Provider Details

I. General information

NPI: 1669522017
Provider Name (Legal Business Name): DAVID PAUL GAYNES L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 STATE ST STE. C
SANTA BARBARA CA
93105-3134
US

IV. Provider business mailing address

3710 STATE ST STE. C
SANTA BARBARA CA
93105-3134
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-6492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 7989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: