Provider Demographics
NPI:1669652376
Name:BATH X-RAY
Entity Type:Organization
Organization Name:BATH X-RAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DALY
Authorized Official - Last Name:KAHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-682-7801
Mailing Address - Street 1:2324 BATH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4330
Mailing Address - Country:US
Mailing Address - Phone:805-682-7807
Mailing Address - Fax:805-687-5342
Practice Address - Street 1:2324 BATH ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4330
Practice Address - Country:US
Practice Address - Phone:805-682-7807
Practice Address - Fax:805-569-5861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFAC27290207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHC132347OtherFLOUROSCOPY
CAFAC27290OtherDEPTARTMENT OF HEALTH
CARHC112502OtherFLUOROSCOPY
CARHC146423OtherFLOUROSCOPY
CARHC161877OtherFLOUROSCOPY
CARHD137416OtherFLOUROSCOPY
CAWG47385AOtherMEDICARE PROVIDER NO
CARHC146423OtherFLOUROSCOPY