Provider Demographics
NPI:1902174782
Name:UNTERTHINER, RUDI ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:RUDI
Middle Name:ALLEN
Last Name:UNTERTHINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4517
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93140-4517
Mailing Address - Country:US
Mailing Address - Phone:760-568-6561
Mailing Address - Fax:
Practice Address - Street 1:406 CORONA DEL MAR
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-3660
Practice Address - Country:US
Practice Address - Phone:760-568-6561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23118208200000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery