Van Deventer, Gary M

Van Deventer, Gary M is an sole proprietor health care provider with primary practice located at 221 W Pueblo St Suite B, Santa Barbara CA 93105-6814. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Van Deventer, Gary M can be contacted via phone (805) 563-0024.

Contact Information

Primary practice address
221 W Pueblo St Suite B Santa Barbara CA 93105-6814
Phone: (805) 563-0024
Fax: (805) 563-1454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X C39157 California

Profile Details

NPI number 1285628933
LBN Legal business name Van Deventer, Gary M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2005
Last updated Mar 24th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285628933 NPPES
California Other 100004009 RAILROAD MEDICARE
California MEDICAID 00C391570 RAILROAD MEDICARE

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