Provider Demographics
NPI:1164449880
Name:HULLANDER AND MOZINGO LP
Entity Type:Organization
Organization Name:HULLANDER AND MOZINGO LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HULLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-563-0363
Mailing Address - Street 1:P.O. BOX 3880
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93130-3880
Mailing Address - Country:US
Mailing Address - Phone:805-563-0363
Mailing Address - Fax:805-563-0364
Practice Address - Street 1:222 W PUEBLO ST STE B
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3805
Practice Address - Country:US
Practice Address - Phone:805-563-0363
Practice Address - Fax:805-563-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68228207L00000X, 208VP0014X
CA20A6316207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18759Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER