1245397298 NPI number — SANTA BARBARA COUNTY AUDITOR

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245397298 NPI number — SANTA BARBARA COUNTY AUDITOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANTA BARBARA COUNTY AUDITOR
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PHYSICIAN'S MEDICAL GROUP
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245397298
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 N SAN ANTONIO RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93110-1316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-681-5461
Provider Business Mailing Address Fax Number:
805-681-5200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1136 E MONTECITO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93103-2635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-568-2036
Provider Business Practice Location Address Fax Number:
805-568-2039
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GAMBLE
Authorized Official First Name:
DANA
Authorized Official Middle Name:
BRUCE
Authorized Official Title or Position:
DEPUTY DIRECTOR
Authorized Official Telephone Number:
805-681-5171

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HAP16130F . This is a "HAP NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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