Provider Demographics
NPI:1245851534
Name:SANTA BARBARA EYECARE INC., A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:SANTA BARBARA EYECARE INC., A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KATSEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-967-9990
Mailing Address - Street 1:2946 DE LA VINA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3310
Mailing Address - Country:US
Mailing Address - Phone:805-967-9990
Mailing Address - Fax:805-883-3898
Practice Address - Street 1:2946 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3310
Practice Address - Country:US
Practice Address - Phone:805-963-1997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1245851534Medicaid