Provider Demographics
NPI:1437190147
Name:TARLETON, GUY W (MD)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:W
Last Name:TARLETON
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:PO BOX 1206
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93116-1206
Mailing Address - Country:US
Mailing Address - Phone:805-696-7920
Mailing Address - Fax:
Practice Address - Street 1:351 S PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2403
Practice Address - Country:US
Practice Address - Phone:805-696-7920
Practice Address - Fax:805-696-7921
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG080855207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G808550Medicaid
H02903Medicare UPIN
CAWG80855IMedicare PIN
CA00G808550Medicaid