Provider Demographics
NPI:1710038104
Name:SANTA BARBARA FOOT CLINIC, A PODIATRY GROUP, INC.
Entity Type:Organization
Organization Name:SANTA BARBARA FOOT CLINIC, A PODIATRY GROUP, INC.
Other - Org Name:SB FOOT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:STEVE
Authorized Official - Last Name:APOSPERIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:805-965-1515
Mailing Address - Street 1:14 E ARRELLAGA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2502
Mailing Address - Country:US
Mailing Address - Phone:805-965-1515
Mailing Address - Fax:805-965-0211
Practice Address - Street 1:14 E ARRELLAGA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2502
Practice Address - Country:US
Practice Address - Phone:805-965-1515
Practice Address - Fax:805-965-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-14
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1323213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WE1063Medicare PIN