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General NPI Number Information
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NPI Number | 1013480128
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Entity Type | Organization
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Legal Business Name | SPINE AND PAIN TREATMENT MEDICAL CENTER OF SANTA BARBARA INC.
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Dates
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Enumeration Date | 01/11/2019
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Last Update Date | 01/11/2019
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Provider Practice Location Address
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Address Line | 1130 COFFEE RD BLDG 5
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City | MODESTO
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State | CA
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Zip | 95355-4228
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Country | US
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Telephone | 805-264-3388
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Fax |
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Provider Business Mailing Address
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Address Line | 218 N I ST
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City | LOMPOC
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State | CA
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Zip | 93436-0909
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Country | US
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Telephone | 805-264-3388
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Fax |
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Authorized Official
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Title or Position | CONTRACT MANAGER
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Name | AMY DAMATO
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Credential |
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Telephone | 805-264-3388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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