Provider Demographics
NPI:1326045634
Name:CARDIOVASCULAR TECHNICAL SERVICES
Entity Type:Organization
Organization Name:CARDIOVASCULAR TECHNICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RDCS/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPLETT
Authorized Official - Suffix:
Authorized Official - Credentials:BA RDCS
Authorized Official - Phone:805-680-3784
Mailing Address - Street 1:401 WINCHESTER CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-1005
Mailing Address - Country:US
Mailing Address - Phone:805-680-3784
Mailing Address - Fax:805-685-3715
Practice Address - Street 1:401 WINCHESTER CANYON RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93117-1005
Practice Address - Country:US
Practice Address - Phone:805-680-3784
Practice Address - Fax:805-685-3715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDCS 24327293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG061Medicare ID - Type UnspecifiedMEDICARE NUMBER