Healthcare Provider Details

I. General information

NPI: 1992140040
Provider Name (Legal Business Name): CHASE ROBERT WARREN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W PUEBLO ST
SANTA BARBARA CA
93105-4353
US

IV. Provider business mailing address

401 QUARRY RD 2204
PALO ALTO CA
94304-1419
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-7259
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA132051
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: