Provider Demographics
NPI:1922035559
Name:KOLARCZYK, ROBERT ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:KOLARCZYK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1801 STATE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2482
Mailing Address - Country:US
Mailing Address - Phone:805-569-1000
Mailing Address - Fax:805-569-1155
Practice Address - Street 1:1801 STATE ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2482
Practice Address - Country:US
Practice Address - Phone:805-569-1000
Practice Address - Fax:805-569-1155
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41910207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C419100OtherBLUE SHIELD PROVIDER #
CA770160386OtherCOMMERCIAL CARRIER ID #
CA00C419100OtherCA MEDICAL PROVIDER #
CA00C419100OtherBLUE SHIELD PROVIDER #
CA770160386OtherCOMMERCIAL CARRIER ID #