Basic Information
| Provider Information | |||||||||
| NPI: | 1225055114 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANDIN | ||||||||
| FirstName: | KARL | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 133 E DE LA GUERRA ST | ||||||||
| Address2: | BOX 170 | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931012228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055698922 | ||||||||
| FaxNumber: | 8056875467 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 W PUEBLO ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931053870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055698922 | ||||||||
| FaxNumber: | 8056875467 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 02/08/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P2900X | G67921 | CA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | GR0040970 | 05 | CA | MEDICAID | 250013409 | 01 | CA | RR MEDICARE | OTHER |