Organization
SANTA BARBARA RADIOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS C. DAUGHTERS M.D. (PRESIDENT)
(805) 569-7279
Entity
Organization
Contact information
Practice address
400 W PUEBLO ST, SANTA BARBARA, CA 93105-4353
(805) 569-7279
(805) 569-8279
Mailing address
PO BOX 4219, ORANGE, CA 92863-4219
(714) 571-5000
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS8932
RAILROAD MEDICARE
—
01
—
ZZZ49598Z
BLUE SHIELD OF CA
—
05
—
ZZZ49598Z
—
CA
Enumeration date
08/18/2005
Last updated
01/20/2014
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