Provider Demographics
NPI:1609937374
Name:BRANDT, JOEL H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:H
Last Name:BRANDT
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 1:1809 CLIFF DR
Mailing Address - Street 2:B
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1641
Mailing Address - Country:US
Mailing Address - Phone:805-966-7159
Mailing Address - Fax:
Practice Address - Street 1:1809 CLIFF DR
Practice Address - Street 2:B
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93109-1641
Practice Address - Country:US
Practice Address - Phone:805-966-7159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34416207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC34416Medicare PIN
CAA87730Medicare UPIN