Healthcare Provider Details
I. General information
NPI: 1306910856
Provider Name (Legal Business Name): SANTA BARBARA PULMONARY AND CRITICAL CARE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2006
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 W PUEBLO ST
SANTA BARBARA CA
93105-4353
US
IV. Provider business mailing address
306 SANTA ROSA LN
SANTA BARBARA CA
93108-2136
US
V. Phone/Fax
- Phone: 805-448-5508
- Fax:
- Phone: 805-448-5508
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | G50207 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | G50207 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
JEFFREY
CHARLES
FRIED
Title or Position: PRESIDENT
Credential: MD
Phone: 805-448-5508