Healthcare Provider Details

I. General information

NPI: 1083969935
Provider Name (Legal Business Name): GINA FARIAS-EISNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 12/22/2023
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 HOLLISTER AVE STE 195
SANTA BARBARA CA
93111-2465
US

IV. Provider business mailing address

5333 HOLLISTER AVE STE 195
SANTA BARBARA CA
93111-2465
US

V. Phone/Fax

Practice location:
  • Phone: 805-967-1359
  • Fax:
Mailing address:
  • Phone: 805-967-1359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA141137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: