Healthcare Provider Details

I. General information

NPI: 1972795573
Provider Name (Legal Business Name): GYNECOLOGIC ONCOLOGY SPECIALISTS,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BATH ST STE 205
SANTA BARBARA CA
93105-4351
US

IV. Provider business mailing address

315 MEIGS RD # A334
SANTA BARBARA CA
93109-1900
US

V. Phone/Fax

Practice location:
  • Phone: 805-324-9144
  • Fax:
Mailing address:
  • Phone: 805-570-7799
  • Fax: 805-980-1742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberA45615
License Number StateCA

VIII. Authorized Official

Name: ANNE RODRIGUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 805-570-7799