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General NPI Number Information
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NPI Number | 1962438341
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Entity Type | Individual
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Provider Name | MARK WIENPAHL MD
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Gender | Male
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 271 N FAIRVIEW AVE STE 101
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City | GOLETA
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State | CA
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Zip | 93117-6284
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Country | US
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Telephone | 805-898-0355
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Fax | 805-682-6933
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Provider Business Mailing Address
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Address Line | 319 N MILPAS ST
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City | SANTA BARBARA
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State | CA
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Zip | 93103-3262
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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 |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23375
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G88817
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License Number State | CA
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