Healthcare Provider Details

I. General information

NPI: 1073777934
Provider Name (Legal Business Name): ROBERT CARR KANARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W PUEBLO ST
SANTA BARBARA CA
93105-4353
US

IV. Provider business mailing address

PO BOX 1359
SAN CLEMENTE CA
92674-1359
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-7111
  • Fax: 949-366-2390
Mailing address:
  • Phone: 949-492-3514
  • Fax: 949-366-2390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberMED-PHYS-LIC-115562
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number036121352
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberA84875
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: