Healthcare Provider Details

I. General information

NPI: 1881934594
Provider Name (Legal Business Name): PUEBLO SANTA BARBARA WOMEN'S IMAGING ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 STATE ST SUITE 102
SANTA BARBARA CA
93101-2500
US

IV. Provider business mailing address

PO BOX 1326
SANTA BARBARA CA
93102-1326
US

V. Phone/Fax

Practice location:
  • Phone: 805-560-8111
  • Fax: 805-560-6900
Mailing address:
  • Phone: 805-682-7984
  • Fax: 805-569-2964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WINIFRED K LEUNG
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 805-682-7984