Provider Demographics
NPI:1003290677
Name:AXELROD, TREVOR (MD)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:AXELROD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W. PUEBLO STREET, MEDICAL EDUCATION OFFICE
Mailing Address - Street 2:SANTA BARBARA COTTAGE HOSPITAL
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105
Mailing Address - Country:US
Mailing Address - Phone:805-569-7315
Mailing Address - Fax:805-569-8358
Practice Address - Street 1:400 W. PUEBLO STREET, MEDICAL EDUCATION OFFICE
Practice Address - Street 2:SANTA BARBARA COTTAGE HOSPITAL
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105
Practice Address - Country:US
Practice Address - Phone:805-569-7315
Practice Address - Fax:805-569-8358
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program