Provider Demographics
NPI:1972135564
Name:SANSUM DIABETES RESEARCH INSTITUTE
Entity Type:Organization
Organization Name:SANSUM DIABETES RESEARCH INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:LYDIA
Authorized Official - Last Name:CANTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-682-7640
Mailing Address - Street 1:2219 BATH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4321
Mailing Address - Country:US
Mailing Address - Phone:805-682-7640
Mailing Address - Fax:805-682-3332
Practice Address - Street 1:2219 BATH ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4321
Practice Address - Country:US
Practice Address - Phone:805-682-7640
Practice Address - Fax:805-682-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty