Healthcare Provider Details

I. General information

NPI: 1063635266
Provider Name (Legal Business Name): JAMES W SPLETTSTOESSER DPM PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 E MISSION ST SUITE B
SANTA BARBARA CA
93101-2459
US

IV. Provider business mailing address

19 E MISSION ST SUITE B
SANTA BARBARA CA
93101-2459
US

V. Phone/Fax

Practice location:
  • Phone: 805-687-6668
  • Fax: 805-687-6669
Mailing address:
  • Phone: 805-687-6668
  • Fax: 805-687-6669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberE19601
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES WILFRED SPLETTSTOESSER
Title or Position: OWNER
Credential: D.P.M.
Phone: 805-687-6668