Healthcare Provider Details

I. General information

NPI: 1609937374
Provider Name (Legal Business Name): JOEL H BRANDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 05/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 CLIFF DR B
SANTA BARBARA CA
93109-1641
US

IV. Provider business mailing address

1809 CLIFF DR B
SANTA BARBARA CA
93109-1641
US

V. Phone/Fax

Practice location:
  • Phone: 805-966-7159
  • Fax:
Mailing address:
  • Phone: 805-966-7159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberC34416
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: