Robert S. P. Fan, MD, a Professional Corporation

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

G810210 Issued in CA

Legal business name

ROBERT S. P. FAN, MD, A PROFESSIONAL CORPORATION

Practice address

1532 State St
2ND Floor
Santa Barbara, CA 93101-2554

Phone

(805) 966-6085

Fax

(805) 966-6086

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert Simon Peter Fan, MD

Title

Ceo

Phone

(805) 966-6085

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982711206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 STATE ST",
            "address_2": "2ND FLOOR",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012554",
            "telephone_number": "805-966-6085",
            "fax_number": "805-966-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 STATE ST",
            "address_2": "2ND FLOOR",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012554",
            "telephone_number": "805-966-6085",
            "fax_number": "805-966-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT S. P. FAN, MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SIMON PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-966-6085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "G810210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G810210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.