Healthcare Provider Details

I. General information

NPI: 1861153140
Provider Name (Legal Business Name): MELISSA DRAKE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 W PUEBLO ST STE 202
SANTA BARBARA CA
93105-6211
US

IV. Provider business mailing address

504 W PUEBLO ST STE 202
SANTA BARBARA CA
93105-6211
US

V. Phone/Fax

Practice location:
  • Phone: 805-455-6500
  • Fax: 805-770-3935
Mailing address:
  • Phone: 805-455-6500
  • Fax: 805-770-3935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MELISSA GEORGENSON DRAKE
Title or Position: PRESIDENT
Credential: MD
Phone: 805-455-6500