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General NPI Number Information
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NPI Number | 1932396421
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Entity Type | Organization
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Legal Business Name | ASSOCIATED EYE SPECIALISTS MEDICAL GROUP INC
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 515 E MICHELTORENA ST STE D
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City | SANTA BARBARA
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State | CA
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Zip | 93103-4224
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Country | US
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Telephone | 805-963-4272
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Fax | 805-563-0883
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Provider Business Mailing Address
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Address Line | 2939 LOMITA RD
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City | SANTA BARBARA
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State | CA
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Zip | 93105-3317
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Country | US
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Telephone | 805-729-3575
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Fax | 805-563-0883
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT WILLIAM POULIN
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Credential | M.D.
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Telephone | 805-729-3575
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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 | G059821
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License Number State | CA
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