Provider Demographics
NPI:1699126904
Name:NADDELL, CLAYTON THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:THOMAS
Last Name:NADDELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W PUEBLO STREET
Mailing Address - Street 2:SBCH MEDICAL EDUCATION OFFICE
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105
Mailing Address - Country:US
Mailing Address - Phone:805-569-7315
Mailing Address - Fax:805-569-7358
Practice Address - Street 1:400 W PUEBLO STREET
Practice Address - Street 2:SBCH MEDICAL EDUCATION OFFICE
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105
Practice Address - Country:US
Practice Address - Phone:805-569-7315
Practice Address - Fax:805-569-7358
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program