Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | G67921 | CA |
NPI | 1225055114 |
---|---|
Provider Name | Karl J Sandin |
First Address | Santa Barbara, CA 93101-2228 |
Second Address | Santa Barbara, CA 93105-3870 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 08/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250013409 | RR MEDICARE (01) | CA |
E51109 | (02) | CA |
GR0040970 | (05) | CA |