Healthcare Provider Details

I. General information

NPI: 1447236336
Provider Name (Legal Business Name): AARON C MCCOLPIN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
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 4749
MEDFORD OR
97501-0227
US

V. Phone/Fax

Practice location:
  • Phone: 805-377-2471
  • Fax: 805-377-2471
Mailing address:
  • Phone: 541-789-5516
  • Fax: 541-789-5518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: