Individual
DR. IGOR V BULATOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 E CHURCH ST, SANTA MARIA, CA 93454-5906
(805) 739-3000
Mailing address
1400 E CHURCH ST, SANTA MARIA, CA 93454-5906
(805) 739-3000
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
81299
WI
207LP3000X
Pediatric Anesthesiology Physician
Primary
A71433
CA
207LP3000X
Pediatric Anesthesiology Physician
MD-52447
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ71868Z
—
CA
Enumeration date
10/03/2006
Last updated
03/14/2024
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