Provider Demographics
NPI:1942234539
Name:SANTA BARBARA INTERNAL MEDICINE GROUP A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SANTA BARBARA INTERNAL MEDICINE GROUP A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-964-9858
Mailing Address - Street 1:PO BOX 6676
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-6676
Mailing Address - Country:US
Mailing Address - Phone:805-964-9858
Mailing Address - Fax:
Practice Address - Street 1:5333 HOLLISTER AVE
Practice Address - Street 2:#201
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2341
Practice Address - Country:US
Practice Address - Phone:805-964-9858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16841Medicare ID - Type Unspecified