Healthcare Provider Details
I. General information
NPI: 1326123209
Provider Name (Legal Business Name): LAGS SPINE & SPORTSCARE MEDICAL CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/26/2006
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
29 W MICHELTORENA ST
SANTA BARBARA CA
93101-2509
US
IV. Provider business mailing address
135 CARMEN LN
SANTA MARIA CA
93458-7729
US
V. Phone/Fax
- Phone: 805-884-4019
- Fax: 805-884-4075
- Phone: 805-928-7361
- Fax: 805-928-5742
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANCIS
P
LAGATTUTA
Title or Position: PRESIDENT
Credential: MD
Phone: 805-928-7361