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General NPI Number Information
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NPI Number | 1114395472
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Entity Type | Organization
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Legal Business Name | SANTA BARBARA ENT
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 2420 CASTILLO ST SUITE 100
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City | SANTA BARBARA
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State | CA
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Zip | 93105-4346
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Country | US
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Telephone | 805-563-1999
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Fax | 805-563-4999
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Provider Business Mailing Address
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Address Line | 2420 CASTILLO STREET SUITE 100
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City | SANTA BARBARA
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State | CA
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Zip | 93105-5307
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Country | US
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Telephone | 805-563-1999
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Fax | 805-563-4999
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Authorized Official
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Title or Position | MD
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Name | REBECCA D GOLGERT
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Credential | M.D.
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Telephone | 805-563-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | A102609
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License Number State | CA
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