1306066816 NPI number — SURGICAL ACCESS ASSOCIATES, INC

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 1306066816 NPI number — SURGICAL ACCESS ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SURGICAL ACCESS ASSOCIATES, INC
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:
Provider Other Organization Name Type Code:
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:
1306066816
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 91903
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:
93190-1903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-617-4544
Provider Business Mailing Address Fax Number:
805-880-0491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
104 W. ANAPAMU STREET
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93101-3126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-617-4544
Provider Business Practice Location Address Fax Number:
805-880-0491
Provider Enumeration Date:
04/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JAMES
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
ACCOUNTING ASSISTANT
Authorized Official Telephone Number:
805-617-4544

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  102836 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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