Provider Demographics
NPI:1962712240
Name:EBLING, MATTHEW JAMES (PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JAMES
Last Name:EBLING
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3880
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93130-3880
Mailing Address - Country:US
Mailing Address - Phone:805-563-0363
Mailing Address - Fax:805-563-0364
Practice Address - Street 1:401 EAST CARRILLO STREET
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101
Practice Address - Country:US
Practice Address - Phone:805-563-3307
Practice Address - Fax:805-563-0998
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21270363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant