MEDICARE: PACIFIC PLASTIC SURGEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA15071	CA

General Provider Information

NPI Number	:	1043586688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC PLASTIC SURGEY

Provider Business Mailing Address
First Line	:	1722 STATE ST
Second Line	:	SUITE 102
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-2458
Country	:	US
Telephone Number	:	805-898-0700
Fax Number	:	805-898-0600

Provider Business Practice Location Address
First Line	:	1722 STATE ST
Second Line	:	SUITE 102
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-2458
Country	:	US
Telephone Number	:	805-898-0700
Fax Number	:	805-898-0600

Authorized Official
Title or Position	:	PHYSICIAN ASSISTANT
Name	:	MS. JESSICA HOPE BARKER
Credential	:	P.A.
Telephone Number	:	805-898-0700

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	11/10/2015

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Directions to “PACIFIC PLASTIC SURGEY ” Practice Location

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