Provider Demographics
NPI:1730419847
Name:INTEGRATIVE MEDICINE CENTER OF SANTA BARBARA INC
Entity type:Organization
Organization Name:INTEGRATIVE MEDICINE CENTER OF SANTA BARBARA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-963-1824
Mailing Address - Street 1:533 E MICHELTORENA ST
Mailing Address - Street 2:SUIT 101
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2200
Mailing Address - Country:US
Mailing Address - Phone:805-963-1824
Mailing Address - Fax:805-963-1826
Practice Address - Street 1:533 E MICHELTORENA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2200
Practice Address - Country:US
Practice Address - Phone:805-963-1824
Practice Address - Fax:805-963-1826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78847208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAET891AMedicare UPIN