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General NPI Number Information
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NPI Number | 1801978952
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Entity Type | Organization
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Legal Business Name | NACC PORT HUNEME
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | NACC 162 FIRST STREET BUILDING 1402
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City | PORT HUENEME
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State | CA
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Zip | 93043-0001
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Country | US
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Telephone | 805-982-6342
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Fax |
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Provider Business Mailing Address
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Address Line | 1485 LAS POSITAS PL
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City | SANTA BARBARA
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State | CA
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Zip | 93105-4525
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OIC
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Name | DAVID WHITE
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Credential | D.O
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Telephone | 805-982-6370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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