Provider Demographics
NPI:1720269889
Name:ARTHRITIS INSTITUTE OF SANTA BARBARA
Entity Type:Organization
Organization Name:ARTHRITIS INSTITUTE OF SANTA BARBARA
Other - Org Name:GUY CLARK MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-682-7570
Mailing Address - Street 1:2419 CASTILLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4301
Mailing Address - Country:US
Mailing Address - Phone:805-682-7570
Mailing Address - Fax:805-687-3776
Practice Address - Street 1:2419 CASTILLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4301
Practice Address - Country:US
Practice Address - Phone:805-682-7570
Practice Address - Fax:805-687-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10009174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G100090Medicaid
CAA37815Medicare UPIN