Basic Information
| Provider Information | |||||||||
| NPI: | 1558471433 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARIWALLA | ||||||||
| FirstName: | KIRAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 62106 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931602106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056817761 | ||||||||
| FaxNumber: | 8056811768 | ||||||||
| Practice Location | |||||||||
| Address1: | 2027 VILLAGE LN | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SOLVANG | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934632283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056883440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 10/26/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | C52068 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | C52068 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.