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General NPI Number Information
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NPI Number | 1124246798
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Entity Type | Individual
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Provider Name | KUM IM WELLS
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 301 N R ST
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City | LOMPOC
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State | CA
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Zip | 93436-5226
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Country | US
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Telephone | 805-737-6473
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Fax |
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Provider Business Mailing Address
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Address Line | 300 N SAN ANTONIO RD
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City | SANTA BARBARA
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State | CA
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Zip | 93110-1316
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Country | US
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Telephone | 805-681-5461
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Fax | 805-681-5200
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 589955
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License Number State | CA
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