Healthcare Provider Details

I. General information

NPI: 1992059695
Provider Name (Legal Business Name): KEVIN EDWARD CAHILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2012
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W PUEBLO ST
SANTA BARBARA CA
93105-4353
US

IV. Provider business mailing address

400 W PUEBLO ST
SANTA BARBARA CA
93105-4353
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-7316
  • Fax:
Mailing address:
  • Phone: 805-569-7316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number111946
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA113975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: