Provider Demographics
NPI:1225055114
Name:SANDIN, KARL J (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:J
Last Name:SANDIN
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 1:133 E DE LA GUERRA ST
Mailing Address - Street 2:BOX 170
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2228
Mailing Address - Country:US
Mailing Address - Phone:805-569-8922
Mailing Address - Fax:805-687-5467
Practice Address - Street 1:230 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3870
Practice Address - Country:US
Practice Address - Phone:805-569-8922
Practice Address - Fax:805-687-5467
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG679212081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0040970Medicaid
CA250013409OtherRR MEDICARE
CA250013409OtherRR MEDICARE
CAWG67921BMedicare ID - Type Unspecified
CAWG67921GMedicare ID - Type Unspecified
CAE51109Medicare UPIN
CAGR0040970Medicaid