Provider Demographics
NPI:1457481814
Name:DONALD E LINDBLAD MD AMC
Entity Type:Organization
Organization Name:DONALD E LINDBLAD MD AMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:LINDBLAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-967-3443
Mailing Address - Street 1:334 S PATTERSON AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2400
Mailing Address - Country:US
Mailing Address - Phone:805-967-3443
Mailing Address - Fax:805-967-1504
Practice Address - Street 1:334 S PATTERSON AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2400
Practice Address - Country:US
Practice Address - Phone:805-967-3443
Practice Address - Fax:805-967-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG14482207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0002220Medicaid
CA00G144820Medicaid
CAZZZ85377ZOtherBLUE SHIELD PIN
CAWG14482AMedicare PIN
CAA39261Medicare UPIN