Healthcare Provider Details

I. General information

NPI: 1396847182
Provider Name (Legal Business Name): ROBERT LEPOSAVIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 HOLLISTER AVE STE 105
SANTA BARBARA CA
93111-3309
US

IV. Provider business mailing address

3827 N 10TH ST STE 305
MCALLEN TX
78501-1745
US

V. Phone/Fax

Practice location:
  • Phone: 805-770-8400
  • Fax: 805-770-8400
Mailing address:
  • Phone: 568-030-7489
  • Fax: 805-681-1768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberA63047
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: