Santa Barbara Medical Group, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A122580 Issued in CA

Legal business name

SANTA BARBARA MEDICAL GROUP, INC.

Practice address

7111 Winnetka Ave
Suite 14
Canoga Park, CA 91306-3672

Phone

(818) 884-8607

Fax

(818) 884-8619

NPI assigned

Apr 5, 2013

Organization subpart

No

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

Authorized official

Name

Nathan Daniel Ford, M.D.

Title

President

Phone

(818) 884-8607

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1912240193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 WINNETKA AVE",
            "address_2": "SUITE 14",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913063672",
            "telephone_number": "818-884-8607",
            "fax_number": "818-884-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 WINNETKA AVE",
            "address_2": "SUITE 14",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913063672",
            "telephone_number": "818-884-8607",
            "fax_number": "818-884-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA BARBARA MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-05",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-884-8607",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A122580",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A122580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.