Provider Demographics
NPI:1316092927
Name:PERKINS, GREG (DPT)
Entity type:Individual
Prefix:MR
First Name:GREG
Middle Name:
Last Name:PERKINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 EAST VALLEY ROAD
Mailing Address - Street 2:SUITE M
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108
Mailing Address - Country:US
Mailing Address - Phone:805-565-5252
Mailing Address - Fax:805-565-5250
Practice Address - Street 1:1470 EAST VALLEY ROAD
Practice Address - Street 2:SUITE M
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108
Practice Address - Country:US
Practice Address - Phone:805-565-5252
Practice Address - Fax:805-565-5250
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPT28936BMedicare ID - Type Unspecified
Y07182Medicare UPIN