Healthcare Provider Details

I. General information

NPI: 1306101787
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL CLAVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 W PUEBLO ST FL 2
SANTA BARBARA CA
93105-6219
US

IV. Provider business mailing address

514 W PUEBLO ST FL 2
SANTA BARBARA CA
93105-6219
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-7751
  • Fax: 805-563-2527
Mailing address:
  • Phone: 805-682-7751
  • Fax: 805-563-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA126978
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: