Organization
GARY M VAN DEVENTER MD
Active
Organization
GARY M VAN DEVENTER MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY M VAN DEVENTER MD (PRESIDENT)
(805) 963-3336
Entity
Organization
Contact information
Practice address
221 W PUEBLO ST, SUITE B, SANTA BARBARA, CA 93105-6814
(805) 563-0024
(805) 563-1454
Mailing address
PO BOX 50706, SANTA BARBARA, CA 93150-0706
(805) 963-3336
(805) 564-3332
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100004009
RAILROAD MEDICARE
CA
Enumeration date
09/26/2007
Last updated
08/18/2009
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