Facts
- Status
- A
- Credential
- M.D.
- Type
- Individual
- Enumeration date
- 2007-02-20
- Last updated
- 2022-07-21
Licenses
- License AZ
- 34311
- License CA
- c138870
Location
- Practice location
- 345 CAMINO DEL REMEDIO
- City
- SANTA BARBARA CA
- Postal code
- 931101332
- Phone
- 805-681-5488
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.