Healthcare Provider Details

I. General information

NPI: 1164974655
Provider Name (Legal Business Name): COASTAL SURGERY CENTER PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W PUEBLO ST STE C
SANTA BARBARA CA
93105-3805
US

IV. Provider business mailing address

121 GRAY AVE STE 200
SANTA BARBARA CA
93101-1800
US

V. Phone/Fax

Practice location:
  • Phone: 805-364-8450
  • Fax:
Mailing address:
  • Phone: 888-282-7472
  • Fax: 805-879-9093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RALPH D MOZINGO
Title or Position: PARTNER
Credential: D.O.
Phone: 805-563-0363