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General NPI Number Information
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NPI Number | 1285763029
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Entity Type | Organization
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Legal Business Name | EYE SURGICAL MEDICAL GROUP OF SANTA BARBARA INC.
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 533 E MICHELTORENA ST SUITE 103
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City | SANTA BARBARA
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State | CA
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Zip | 93103-2200
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Country | US
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Telephone | 805-564-8917
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Fax | 805-564-8917
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Provider Business Mailing Address
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Address Line | 533 E MICHELTORENA ST SUITE 103
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City | SANTA BARBARA
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State | CA
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Zip | 93103-2200
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Country | US
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Telephone | 805-564-8917
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Fax | 805-564-8917
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM HAROLD COULTER
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Credential | M.D.
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Telephone | 805-564-8917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C29906
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License Number State | CA
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