Healthcare Provider Details

I. General information

NPI: 1588798300
Provider Name (Legal Business Name): SOUTH COAST NUCLEAR MEDICINE MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 W PUEBLO ST
SANTA BARBARA CA
93105-3804
US

IV. Provider business mailing address

PO BOX 30978
SANTA BARBARA CA
93130-0978
US

V. Phone/Fax

Practice location:
  • Phone: 805-563-5744
  • Fax: 805-563-5747
Mailing address:
  • Phone: 805-964-1814
  • Fax: 805-964-7154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberG58652
License Number StateCA

VIII. Authorized Official

Name: DANIEL STEVEN RIMKUS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-563-5744