Provider Demographics
NPI:1730182767
Name:SCHLEGEL, GARY LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:LEE
Last Name:SCHLEGEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2165 ALISOS DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-1502
Mailing Address - Country:US
Mailing Address - Phone:805-565-3234
Mailing Address - Fax:805-682-6394
Practice Address - Street 1:222 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3805
Practice Address - Country:US
Practice Address - Phone:805-682-1394
Practice Address - Fax:805-682-6394
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2551213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E25511Medicaid
CA000E25510Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CA000E25511Medicaid