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NPI Code Detail

MEDICARE: MICHAEL ISIDRO POLO M.D.

MEDICARE: MICHAEL ISIDRO POLO 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
12084P0800XPsychiatry PhysicianA107883CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A107883OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1942347257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ISIDRO POLO 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 : 3916 STATE ST STE 300
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-3137
Country : US
Telephone Number : 805-681-7517
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 01/25/2019

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Directions to “ MICHAEL ISIDRO POLO M.D.” Practice Location

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