Provider Demographics
NPI:1487865671
Name:MATHIS, ROBERT P (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:MATHIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4187
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93140-4187
Mailing Address - Country:US
Mailing Address - Phone:805-569-7100
Mailing Address - Fax:805-569-7113
Practice Address - Street 1:1625 STATE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2539
Practice Address - Country:US
Practice Address - Phone:805-569-7100
Practice Address - Fax:805-569-7113
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
CAA46123207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC34684Medicare UPIN