Provider Demographics
NPI:1740396845
Name:POLYNICE, ALAIN
Entity type:Individual
Prefix:DR
First Name:ALAIN
Middle Name:
Last Name:POLYNICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 COAST VILLAGE RD STE L
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2720
Mailing Address - Country:US
Mailing Address - Phone:805-962-1957
Mailing Address - Fax:
Practice Address - Street 1:1250 COAST VILLAGE RD STE L
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-2720
Practice Address - Country:US
Practice Address - Phone:805-962-1957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205376208200000X
CAC173219208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY205376OtherSTATE LICENSE
NY02118656Medicaid
NY02118656Medicaid
NY205376OtherSTATE LICENSE