Healthcare Provider Details

I. General information

NPI: 1063620573
Provider Name (Legal Business Name): DANIEL N. OVADIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 ALAMEDA PADRE SERRA STE 109
SANTA BARBARA CA
93103-1760
US

IV. Provider business mailing address

2040 ALAMEDA PADRE SERRA SUITE 109
SANTA BARBARA CA
93103
US

V. Phone/Fax

Practice location:
  • Phone: 805-965-2336
  • Fax: 805-965-2666
Mailing address:
  • Phone: 805-965-2336
  • Fax: 805-965-2666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG54940
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: