Provider Demographics
NPI:1972574325
Name:BESSEGA, SAMANTHA L (MD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:L
Last Name:BESSEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 CALLE REAL
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1002
Mailing Address - Country:US
Mailing Address - Phone:805-683-1491
Mailing Address - Fax:805-683-3631
Practice Address - Street 1:4440 CALLE REAL
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1002
Practice Address - Country:US
Practice Address - Phone:805-683-1491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC55105207R00000X
MA214145207R00000X, 207RI0200X
FLME98891207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
042881348OtherUNICARE
MA1305557Medicaid
469890OtherTUFTS
3645499OtherAETNA
042881348OtherCHOICECARE
8796861OtherCIGNA
970501OtherNETWORK HEALTH
042881348OtherONE HEALTH
AA14488OtherHARVARD PILGRIM HEALTHCAR
FLCZ148ZOtherMEDICARE PTAN
0033095OtherNEIGHBORHOOD HEALTH PLAN
042881348OtherBEECH STREET
80909OtherFALLON
J27740OtherBLUE CROSS BLUE SHIELD
MA1305557Medicaid