Provider Demographics
NPI:1407876774
Name:CUMMINGS, DOUGLAS E (MD)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:E
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:429 SAN MARINO DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2616
Mailing Address - Country:US
Mailing Address - Phone:805-964-1912
Mailing Address - Fax:
Practice Address - Street 1:5333 HOLLISTER AVE STE 110
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2379
Practice Address - Country:US
Practice Address - Phone:805-683-0055
Practice Address - Fax:805-683-0149
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57967207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABC0878605OtherDEA #
CABC0878605OtherDEA #