Healthcare Provider Details

I. General information

NPI: 1497839161
Provider Name (Legal Business Name): CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 S PATTERSON AVE SUITE 210
SANTA BARBARA CA
93111
US

IV. Provider business mailing address

334 S PATTERSON AVE SUITE 210
SANTA BARBARA CA
93111
US

V. Phone/Fax

Practice location:
  • Phone: 805-967-0497
  • Fax: 805-683-0322
Mailing address:
  • Phone: 805-967-0497
  • Fax: 805-683-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: R BRUCE MCFADDEN
Title or Position: PRESIDENT
Credential: MD FACC
Phone: 805-967-0497