NPIMap

Organization Active NPI

Ageless Men's Health Ca, PC

Doing business as Ageless Men's Health

  • Internal Medicine Physician
  • Santa Barbara, CA
National Provider Identifier
1285931436
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AGELESS MEN'S HEALTH CA, PC
Doing business as
Ageless Men's Health
Practice address
3905 State Street
#3
Santa Barbara, CA 93105-5101
Phone
(805) 687-8378
Fax
(805) 687-8378
NPI assigned
Feb 24, 2011
Last updated
Nov 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda Wilkinson
Title
Business Operations Director
Phone
(702) 818-0446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

3905 State Street
#3
Santa Barbara, CA 93105-5101

Mailing address

3905 State Street
#3
Santa Barbara, CA 93105-5101
Phone (805) 687-8378

Other names 1

  • Ageless Men's Health Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2034232Ageless Men's Health - Santa Barbara3905 State Street, Suite 3, Santa Barbara, CA 93105Certificate of waiverDec 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ageless Men's Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6825 Quail Hill Pkwy
Irvine, CA 92603
Phone (949) 854-8378

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1285931436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 STATE STREET",
            "address_2": "#3",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931055101",
            "telephone_number": "805-687-8378",
            "fax_number": "805-687-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 STATE STREET",
            "address_2": "#3",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931055101",
            "telephone_number": "805-687-8378",
            "fax_number": "805-687-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS MEN'S HEALTH CA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-24",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "702-818-0446"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageless Men's Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ageless Men's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.