Organization
KENNETH WAXMAN, MD PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH WAXMAN MD (PRESIDENT)
(805) 565-9863
Entity
Organization
Contact information
Practice address
1187 COAST VILLAGE RD, #492, SANTA BARBARA, CA 93108-2737
(805) 565-9863
Mailing address
1187 COAST VILLAGE RD, #492, SANTA BARBARA, CA 93108-2737
(805) 565-9863
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G328720
CA
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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