Individual
KENNETH WAXMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 W PUEBLO ST, SANTA BARBARA, CA 93105-4311
(805) 569-7316
(805) 569-7317
Mailing address
1187 COAST VILLAGE RD, 492, SANTA BARBARA, CA 93108-2737
(805) 569-7316
(805) 569-7317
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G32872
CA
Other
Enumeration date
01/26/2006
Last updated
08/29/2007
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