Provider Demographics
NPI:1770681116
Name:KOWBLANSKY, ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:KOWBLANSKY
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 1:4070 SONRIENTE RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-2445
Mailing Address - Country:US
Mailing Address - Phone:805-682-5354
Mailing Address - Fax:805-682-5351
Practice Address - Street 1:147 N BRENT ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2809
Practice Address - Country:US
Practice Address - Phone:805-652-5011
Practice Address - Fax:805-585-3007
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51029146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZA56032OtherBLUE SHIELD
CA050394OtherBLUE CROSS
CAG51029OtherLICENSE NUMBER
CAHSC30394FMedicaid
CAZZZ53994ZOtherBLUE SHIELD
CAZZT40394FMedicaid
CAWG51029BMedicare PIN
CA050394OtherBLUE CROSS
CAG51029OtherLICENSE NUMBER