Healthcare Provider Details

I. General information

NPI: 1881014983
Provider Name (Legal Business Name): ELIZABETH PATBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 W PUEBLO ST STE A
SANTA BARBARA CA
93105-6206
US

IV. Provider business mailing address

333 CITY BLVD W STE 1400
ORANGE CA
92868-5900
US

V. Phone/Fax

Practice location:
  • Phone: 805-898-0258
  • Fax:
Mailing address:
  • Phone: 609-915-2854
  • Fax: 714-456-7180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA155025
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberA155025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: