Basic Information
| Provider Information | |||||||||
| NPI: | 1477589794 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | EKWA-EKOKO | ||||||||
| FirstName: | CATHERINE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 W PUEBLO STREET | ||||||||
| Address2: | SANTA BARBARA COTTAGE HOSPITAL NICU | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931054353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055697510 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 W PUEBLO STREET | ||||||||
| Address2: | SANTA BARBARA COTTAGE HOSPITAL | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055697510 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | C54636 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 866618 | 05 | AZ | MEDICAID |