Healthcare Provider Details

I. General information

NPI: 1952533820
Provider Name (Legal Business Name): RICHARD JASON HARTMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E CARRILLO ST
SANTA BARBARA CA
93101-1460
US

IV. Provider business mailing address

401 E CARRILLO ST
SANTA BARBARA CA
93101-1460
US

V. Phone/Fax

Practice location:
  • Phone: 805-563-3307
  • Fax: 805-563-0998
Mailing address:
  • Phone: 805-563-3307
  • Fax: 805-563-0998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberOT011705
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: