Provider Demographics
NPI:1508001579
Name:HEUSER, GUNNAR (MD)
Entity Type:Individual
Prefix:
First Name:GUNNAR
Middle Name:
Last Name:HEUSER
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 1:923 LAGUNA ST.
Mailing Address - Street 2:STE B
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101
Mailing Address - Country:US
Mailing Address - Phone:310-500-0041
Mailing Address - Fax:
Practice Address - Street 1:923 LAGUNA ST
Practice Address - Street 2:STE B
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1465
Practice Address - Country:US
Practice Address - Phone:310-500-0041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA20853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine