MEDICARE: SANTA BARBARA OPEN MRI

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	293D00000X	Physiological Laboratory

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ09034Z	OTHER	CA	BLUE SHIELD OF CALIFORNIA

General Provider Information

NPI Number	:	1790724771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA BARBARA OPEN MRI

Provider Business Mailing Address
First Line	:	350 CHAPALA ST
Second Line	:	#104
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-8053
Country	:	US
Telephone Number	:	805-966-0877
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 CHAPALA ST
Second Line	:	#104
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-8053
Country	:	US
Telephone Number	:	805-966-0877
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	ROSS SEIBERT
Credential	:
Telephone Number	:	858-455-7127

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	08/22/2020

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