Basic Information
| Provider Information | |||||||||
| NPI: | 1356768766 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANTA BARBARA CLINIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 50706 | ||||||||
| Address2: | (512 E GUTIERREZ STREET, SUITE C) | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931500706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059633757 | ||||||||
| FaxNumber: | 8055643332 | ||||||||
| Practice Location | |||||||||
| Address1: | 314 E CARRILLO ST | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931011499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058864370 | ||||||||
| FaxNumber: | 8058458227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2014 | ||||||||
| LastUpdateDate: | 03/30/2015 | ||||||||
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| AuthorizedOfficialLastName: | PAYNE | ||||||||
| AuthorizedOfficialFirstName: | MATTHEW | ||||||||
| AuthorizedOfficialMiddleName: | STEVEN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8058864370 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A124622 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.