Provider Demographics
NPI:1184793507
Name:HOLMES, DOROTHY (MD)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N MILPAS ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2331
Mailing Address - Country:US
Mailing Address - Phone:805-617-7858
Mailing Address - Fax:805-963-8880
Practice Address - Street 1:1900 STATE ST
Practice Address - Street 2:SUITE G
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2429
Practice Address - Country:US
Practice Address - Phone:805-617-7858
Practice Address - Fax:805-898-2002
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44448207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A444480Medicaid
CAA44448OtherPHYSICIAN & SURGEON LICEN
CA00A444480Medicaid
CAE96828Medicare UPIN