Healthcare Provider Details

I. General information

NPI: 1356490296
Provider Name (Legal Business Name): LAUREL J MEHLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 HOLLISTER AVE STE 220
SANTA BARBARA CA
93111-3335
US

IV. Provider business mailing address

5333 HOLLISTER AVE STE 220
SANTA BARBARA CA
93111-3335
US

V. Phone/Fax

Practice location:
  • Phone: 805-681-2550
  • Fax: 805-681-2553
Mailing address:
  • Phone: 805-681-2550
  • Fax: 805-681-2553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG71753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: