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NPI Code Detail

MEDICARE: DR. PETER FORD M.D.

MEDICARE: DR. PETER FORD M.D.
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
1207N00000XDermatology PhysicianA68809CA

General Provider Information

NPI Number : 1164451639
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER FORD M.D.
Provider Business Mailing Address
First Line : PO BOX 62106
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93160-2106
Country : US
Telephone Number : 805-681-1761
Fax Number : 805-681-1768
Provider Business Practice Location Address
First Line : 317 W PUEBLO ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-4355
Country : US
Telephone Number : 805-681-1761
Fax Number : 805-681-1768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 10/31/2011

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