Provider Demographics
NPI:1740269174
Name:HOT SPRINGS MEDICAL SURGICAL GROUP
Entity type:Organization
Organization Name:HOT SPRINGS MEDICAL SURGICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GROUP PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-682-2267
Mailing Address - Street 1:2323 DE LA VINA ST
Mailing Address - Street 2:STE 201
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3877
Mailing Address - Country:US
Mailing Address - Phone:805-682-2267
Mailing Address - Fax:805-898-9686
Practice Address - Street 1:2323 DE LA VINA ST
Practice Address - Street 2:STE 201
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3877
Practice Address - Country:US
Practice Address - Phone:805-682-2267
Practice Address - Fax:805-563-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ061932OtherBLUE SHIELD PROVIDER ID
CAW16513AOtherMEDICARE PTAN
CAGR0095130Medicaid
CAGR0095130Medicaid
CA4906100001Medicare NSC
CAZZZ061932OtherBLUE SHIELD PROVIDER ID
CAG18375Medicare UPIN
CAA22699Medicare UPIN
CAW16513Medicare ID - Type Unspecified
MT000084412Medicare PIN