=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326096785
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM MICHAEL PACE MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2006
-----------------------------------------------------
Last Update Date | 06/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2438 N PONDEROSA DR, STE C210 - C213
-----------------------------------------------------
City | CAMARILLO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93010-2369
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-971-1492
-----------------------------------------------------
Fax | 805-301-1492
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 237 SALIDA DEL SOL
-----------------------------------------------------
City | SANTA BARBARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93109-2019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-637-1313
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207U00000X
-----------------------------------------------------
Taxonomy Name | Nuclear Medicine Physician
-----------------------------------------------------
License Number | A54532
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------