Provider Demographics
NPI:1891809984
Name:FLANIGAN, DONALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:FLANIGAN
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 1:320 W JUNIPERO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4305
Mailing Address - Country:US
Mailing Address - Phone:805-682-5803
Mailing Address - Fax:805-687-2763
Practice Address - Street 1:320 W JUNIPERO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4305
Practice Address - Country:US
Practice Address - Phone:805-682-5803
Practice Address - Fax:805-687-2763
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG235680174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G235680Medicaid
CAG235680Medicare ID - Type Unspecified
CA00G235680Medicaid