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General NPI Number Information
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NPI Number | 1619961257
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Entity Type | Individual
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Provider Name | GARY S NOVATT MD
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Gender | Male
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 2320 BATH ST STE 205
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City | SANTA BARBARA
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State | CA
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Zip | 93105
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Country | US
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Telephone | 805-569-1164
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Fax | 805-569-1094
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Provider Business Mailing Address
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Address Line | 2285 CORPORATE CIR STE 200
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City | HENDERSON
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State | NV
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Zip | 89074-7759
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Country | US
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Telephone | 702-360-2763
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Fax | 949-783-2880
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | G56325
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License Number State | CA
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