Healthcare Provider Details
I. General information
NPI: 1104141993
Provider Name (Legal Business Name): ASHER ISAAC KUPPERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/05/2010
Last Update Date: 05/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
511 BATH ST
SANTA BARBARA CA
93101-3403
US
IV. Provider business mailing address
511 BATH ST
SANTA BARBARA CA
93101-3403
US
V. Phone/Fax
- Phone: 805-963-9377
- Fax: 805-962-2154
- Phone: 805-963-9377
- Fax: 805-962-2154
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | PENDING |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0105X |
| Taxonomy | Surgery of the Hand (Surgery) Physician |
| License Number | A118689 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: