Provider Demographics
NPI:1558531053
Name:BUELLTON MEDICAL CENTER
Entity Type:Organization
Organization Name:BUELLTON MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-964-4428
Mailing Address - Street 1:5007 CAIRE CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:185 W HIGHWAY 246
Practice Address - Street 2:SUITE 102
Practice Address - City:BUELLTON
Practice Address - State:CA
Practice Address - Zip Code:93427-9458
Practice Address - Country:US
Practice Address - Phone:805-686-8555
Practice Address - Fax:805-686-8556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty