Individual
BENJAMIN NICHOLAS DIRKX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
401 E CARRILLO ST, SANTA BARBARA, CA 93101-1460
(805) 563-3307
(805) 563-0998
Mailing address
720 MESA DR, SOLVANG, CA 93463-2046
(517) 896-9217
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5101018828
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A13373
MEDICAL BOARD LICENSE
CA
01
—
CA129679
NORTHERN MEDICARE PTAN
CA
01
—
CB220127
SOUTHERN MEDICARE PTAN
CA
Enumeration date
12/01/2010
Last updated
12/16/2024
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