Active NPI
Mark Bruno Kofler, M.D.
- Psychiatry Physician
- Santa Barbara, CA
National Provider Identifier
1679629067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A 30871
- Practice address
- 4444 Calle Real
Santa Barbara, CA 93110-1002 - Phone
- (805) 681-5190
- Fax
- (805) 681-5316
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A 30871 | CA | Primary |
Addresses
Primary practice location
4444 Calle Real
Santa Barbara, CA 93110-1002
Mailing address
935 Coyote Rd
Santa Barbara, CA 93108-1018
Phone (805) 969-1500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A 30871 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679629067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 COYOTE RD",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931081018",
"telephone_number": "805-969-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 CALLE REAL",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931101002",
"telephone_number": "805-681-5190",
"fax_number": "805-681-5316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOFLER",
"first_name": "MARK",
"middle_name": "BRUNO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A 30871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.