Healthcare Provider Details

I. General information

NPI: 1528105038
Provider Name (Legal Business Name): SANTA BARBARA CARDIOVASCULAR MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BATH ST SUITE 201
SANTA BARBARA CA
93105-4351
US

IV. Provider business mailing address

2400 BATH ST SUITE 201
SANTA BARBARA CA
93105-4351
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-7707
  • Fax: 805-682-7710
Mailing address:
  • Phone: 805-682-7707
  • Fax: 805-682-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. PATRICIA A BOARD
Title or Position: ADMINISTRATOR
Credential:
Phone: 805-682-7707