MEDICARE: KIRK S. GILBERT 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
1	207Q00000X	Family Medicine Physician	G45440	CA

General Provider Information

NPI Number	:	1346242344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRK S. GILBERT M.D.

Provider Business Mailing Address
First Line	:	200 N LA CUMBRE RD
Second Line	:	#E
City	:	SANTA BARBARA
State	:	CA
Zip	:	93110-1577
Country	:	US
Telephone Number	:	805-687-1505
Fax Number	:	805-682-8241

Provider Business Practice Location Address
First Line	:	200 N LA CUMBRE RD
Second Line	:	#E
City	:	SANTA BARBARA
State	:	CA
Zip	:	93110-1577
Country	:	US
Telephone Number	:	805-687-1505
Fax Number	:	805-682-8241

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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