Healthcare Provider Details

I. General information

NPI: 1962495887
Provider Name (Legal Business Name): CENTRAL COAST PEDIATRIC HEMATOLOGY ONCOLOGY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2329 OAK PARK LN
SANTA BARBARA CA
93105-4280
US

IV. Provider business mailing address

2329 OAK PARK LN
SANTA BARBARA CA
93105-4280
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-8394
  • Fax: 805-569-8398
Mailing address:
  • Phone: 805-569-8394
  • Fax: 805-569-8398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL GREENFIELD
Title or Position: OWNER/DIRECTOR
Credential: M.D.
Phone: 805-569-8394