Provider Demographics
NPI:1124152293
Name:SANTA BARBARA ORTHOPEDIC ASSOCIATES, INC
Entity type:Organization
Organization Name:SANTA BARBARA ORTHOPEDIC ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DALY
Authorized Official - Last Name:KAHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-682-7801
Mailing Address - Street 1:2428 CASTILLO ST STE E
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5312
Mailing Address - Country:US
Mailing Address - Phone:805-682-7801
Mailing Address - Fax:805-569-5861
Practice Address - Street 1:2324 BATH ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4330
Practice Address - Country:US
Practice Address - Phone:805-682-7801
Practice Address - Fax:805-569-5861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21098207X00000X
CAG47385207X00000X
CAG73901207X00000X
CAA65716207X00000X
CAG51723207XS0117X
CAPA15590363AS0400X
CAA83334207X00000X
207RS0010X
CAP65360363AS0400X
CA530266363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CI613ZOtherUPIN H88324 PTAN IS CI613Z
CAW745OtherPTAN
CI613ZMedicare PIN
CAW745OtherPTAN
CAI24612Medicare UPIN
CAW745Medicare PIN
CI613ZOtherUPIN H88324 PTAN IS CI613Z
CAU68010Medicare UPIN
CAF17011Medicare UPIN
CAP65360Medicare UPIN
P88748Medicare UPIN
CAE02709Medicare UPIN
CAA50674Medicare UPIN
CAH88324Medicare UPIN
CAWPA15590AMedicare PIN