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General NPI Number Information
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NPI Number | 1013050814
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Entity Type | Organization
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Legal Business Name | RECOVERY ROAD MEDICAL CENTER
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 12/08/2017
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Provider Practice Location Address
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Address Line | 1602 STATE STREET
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City | SANTA BARBARA
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State | CA
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Zip | 93101-2520
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Country | US
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Telephone | 805-962-7800
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Fax | 805-962-9002
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Provider Business Mailing Address
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Address Line | PO BOX 3770
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City | SANTA BARBARA
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State | CA
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Zip | 93130-3770
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Country | US
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Telephone | 805-962-7800
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Fax | 805-962-9002
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Authorized Official
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Title or Position | BILLING MGR
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Name | MRS. WILMA CALDER
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Credential |
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Telephone | 707-246-9585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 420034AP
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 959161
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License Number State | CA
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