Basic Information
| Provider Information | |||||||||
| NPI: | 1144250697 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANTA BARBARA COUNTY PUBLIC HEALTH DEPT | ||||||||
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| OtherOrganizationName: | PHYSICIANS' MEDICAL GROUP | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 N SAN ANTONIO RD | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931101316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056815461 | ||||||||
| FaxNumber: | 8056815200 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 S PALISADE DR | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934548902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057398710 | ||||||||
| FaxNumber: | 8057398711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SNYDER | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | ASSISTANT DEPUTY DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8056815252 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | C51193 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | C51193 | 01 | CA | MED LICENSE | OTHER |