Basic Information
| Provider Information | |||||||||
| NPI: | 1073087532 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UROLOGY SPECIALISTS OF SANTA BARBARA INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1206 | ||||||||
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| City: | GOLETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931161206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054657948 | ||||||||
| FaxNumber: | 8056833400 | ||||||||
| Practice Location | |||||||||
| Address1: | 5333 HOLLISTER AVE STE 275 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931112472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056877719 | ||||||||
| FaxNumber: | 8056822971 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2019 | ||||||||
| LastUpdateDate: | 01/17/2019 | ||||||||
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| AuthorizedOfficialLastName: | CHACKO | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8056877719 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.