Provider Demographics
NPI:1265023618
Name:DUKESHERER MEDICAL CORPORATION
Entity Type:Organization
Organization Name:DUKESHERER MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-733-4869
Mailing Address - Street 1:836 ANACAPA ST # 20058
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93102-7001
Mailing Address - Country:US
Mailing Address - Phone:805-464-6104
Mailing Address - Fax:805-733-1213
Practice Address - Street 1:320 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4311
Practice Address - Country:US
Practice Address - Phone:805-464-6104
Practice Address - Fax:805-733-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty