Organization
MICHAEL JAY PAVELOFF M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY SPARKS (BILLING MGR)
(661) 869-2600
Entity
Organization
Contact information
Practice address
1933 CLIFF DR, SUITE 29, SANTA BARBARA, CA 93109-1520
(805) 682-4459
Mailing address
PO BOX 9819, BAKERSFIELD, CA 93389-9819
(805) 682-4459
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G78490
CA
208600000X
Surgery Physician
G78490
CA
332B00000X
Durable Medical Equipment & Medical Supplies
4469950001
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4557534
AETNA
CA
Enumeration date
04/12/2007
Last updated
02/17/2017
Update your record
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