Provider Demographics
NPI:1821090887
Name:LINDBLAD, DONALD E (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:LINDBLAD
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 1:334 S PATTERSON AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2400
Mailing Address - Country:US
Mailing Address - Phone:805-967-3443
Mailing Address - Fax:805-967-1504
Practice Address - Street 1:334 S PATTERSON AVE
Practice Address - Street 2:STE 203
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2400
Practice Address - Country:US
Practice Address - Phone:805-967-3443
Practice Address - Fax:805-967-1504
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2007-07-09
Deactivation Date:2006-04-04
Deactivation Code:
Reactivation Date:2006-04-19
Provider Licenses
StateLicense IDTaxonomies
CAG14482207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0002220Medicaid
CA00G144820Medicaid
CAZZZ85377ZOtherBLUE SHIELD PIN
CAW3835Medicare ID - Type UnspecifiedMEDICARE GROUP ID
CAGR0002220Medicaid
CAWG14482AMedicare PIN