Provider Demographics
NPI:1336338730
Name:PACIFIC ARTHRITIS CENTER MEDICAL GROUP
Entity Type:Organization
Organization Name:PACIFIC ARTHRITIS CENTER MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KOLBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-925-8899
Mailing Address - Street 1:607 E PLAZA DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6944
Mailing Address - Country:US
Mailing Address - Phone:805-925-8899
Mailing Address - Fax:
Practice Address - Street 1:607 E PLAZA DR
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6944
Practice Address - Country:US
Practice Address - Phone:805-925-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14256Medicare PIN