MEDICARE: K CHARMIAN DRESEL-VELASQUEZ MD

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	207V00000X	Obstetrics & Gynecology Physician	A105955	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A105955	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1356509699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	K CHARMIAN DRESEL-VELASQUEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 62106
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93160-2106
Country	:	US
Telephone Number	:	805-681-1760
Fax Number	:	805-681-1768

Provider Business Practice Location Address
First Line	:	515 W PUEBLO ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-6212
Country	:	US
Telephone Number	:	805-681-8911
Fax Number	:	805-898-3488

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

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	11/09/2015

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