Individual
CHADLER R BURGOYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
SANSUM ORTHOPEDIC CLINIC, 4151 FOOTHILL RD - BLDG A, SANTA BARBARA, CA 93110
(805) 681-7500
Mailing address
SANSUM ORTHOPEDIC CLINIC, 4151 FOOTHILL RD - BLDG A, SANTA BARBARA, CA 93110
(805) 681-7500
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD154654
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A99619
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225006760
GROUP NPI #
SC
01
—
1326287434
MEDICAID DME NPI
SC
01
—
1701
GROUP MEDICARE
SC
01
—
20076508
SELECT HEALTH DME
SC
01
—
20081812
SELECT HEALTH FIRST CHOICE
SC
05
—
312851
—
SC
01
—
57-0634057
GROUP TAX ID #
SC
Enumeration date
09/14/2007
Last updated
04/05/2018
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