Provider Demographics
NPI:1356665475
Name:ISSELS MEDICAL CENTER
Entity Type:Organization
Organization Name:ISSELS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLEFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-962-2126
Mailing Address - Street 1:1532 STATE ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2554
Mailing Address - Country:US
Mailing Address - Phone:805-962-2126
Mailing Address - Fax:805-962-2127
Practice Address - Street 1:1532 STATE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2554
Practice Address - Country:US
Practice Address - Phone:805-962-2126
Practice Address - Fax:805-962-2127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86185261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA86185OtherSTATE