Provider Demographics
NPI:1093152324
Name:PALLIATIVE CARE CONSULTANTS OF SANTA BARBARA
Entity Type:Organization
Organization Name:PALLIATIVE CARE CONSULTANTS OF SANTA BARBARA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BORDOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-699-6066
Mailing Address - Street 1:515 E MICHELTORENA ST STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-4223
Mailing Address - Country:US
Mailing Address - Phone:805-563-3234
Mailing Address - Fax:
Practice Address - Street 1:515 E MICHELTORENA ST STE C
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-4223
Practice Address - Country:US
Practice Address - Phone:805-699-6066
Practice Address - Fax:805-456-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75364207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty