Healthcare Provider Details

I. General information

NPI: 1922687391
Provider Name (Legal Business Name): SOUTH COAST NEUROLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 STATE ST STE 203
SANTA BARBARA CA
93101-8453
US

IV. Provider business mailing address

2455 CALLE LINARES
SANTA BARBARA CA
93109-1131
US

V. Phone/Fax

Practice location:
  • Phone: 805-220-4300
  • Fax: 805-620-7676
Mailing address:
  • Phone: 805-220-4300
  • Fax: 805-620-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALEXANDRA BOCIAN
Title or Position: DIRECTOR OF HUMAN RESOURCE
Credential:
Phone: 805-220-4300