GLENN WOLLMAN (NPI# 1679801963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679801963 |
| Entity Type | Individual |
| Full Name | GLENN WOLLMAN |
| Credential | MD |
| Practice Address |
1543 Portesuello Ave Santa Barbara CA 93105-4626 |
| Practice Telephone | 8055695768 |
| Practice Fax Number | 8056873070 |
| Mailing Telephone | 8055695768 |
| Mailing Fax Number | 8056873070 |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2009-11-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | C36169 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C361690 | 05 |
| Street Address |
1543 PORTESUELLO AVE |
| City | SANTA BARBARA |
| State | CA |
| Zip Code | 93105-4626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831716307 | Christopher Robert Ray Hyde | Student in an Organized Health Care Education/Training Program | Santa Barbara Cottage Hospital- Medical Education, 400 W Pueblo Street, Santa Barbara, CA 93105 | 2020-07-01 |
| 1023635562 | Yana Gristan | Student in an Organized Health Care Education/Training Program | Santa Barbara Cottage Hospital - Medical Education, 400 W Pueblo Street, Santa Barbara, CA 93105 | 2020-07-01 |
| 1346867918 | Neelima Archana Mohan | Student in an Organized Health Care Education/Training Program | Santa Barbara Cottage Hospital-medical Education, 400 W Pueblo Street, Santa Barbara, CA 93105 | 2020-06-30 |
| 1861019358 | Jerry Peng Jiang | Student in an Organized Health Care Education/Training Program | Santa Barbara Cottage Hospital -medical Education, 400 W Pueblo Street, Santa Barbara, CA 93105 | 2020-06-30 |
| 1073153250 | California Telemedicine Associates, P.C. | Pediatrics | 2830 Glendessary Lane, Santa Barbara, CA 93105 | 2020-01-15 |
| 1275190233 | Paul Seo | Student in an Organized Health Care Education/Training Program | Sbch Medical Education, 400 W Pueblo Street, Santa Barbara, CA 93105 | 2019-05-24 |
| 1174009062 | Hannah Wilks Kornfeld | Student in an Organized Health Care Education/Training Program | Sbch, Surgical Education, 400 W Pueblo Street, Santa Barbara, CA 93105 | 2018-07-14 |
| 1174010896 | Thuthiri Thandar Lwin | Student in an Organized Health Care Education/Training Program | Sbch Medical Education Office, 400 W Pueblo Street, Santa Barbara, CA 93105 | 2018-04-18 |
| 1649771056 | Jeremy Middleton | Student in an Organized Health Care Education/Training Program | Sbch, Medical Education Office, 400 W Pueblo Street, Santa Barbara, CA 93105 | 2018-02-22 |
| 1720593502 | Spencer E Price | Radiology | 400 W Pueblo St Dept Of, Santa Barbara, CA 93105 | 2017-12-03 |
| Find all providers in zip 93105 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760784474 | Erika J Thost | General Practice | 125 W Micheltorena St, #c, Santa Barbara, CA 93101-3083 | 2010-12-01 |
| 1699910083 | Jeffrey Charles Edman | General Practice | 107 W Gutierrez St, Santa Barbara, CA 93101 | 2008-12-12 |
| 1265629893 | Michael C. Bordofsky Md | General Practice | 2320 Bath St Ste 201, Santa Barbara, CA 93105-4344 | 2007-09-27 |
| 1235354432 | Laurence Ronald Dworet | General Practice | 475 Toro Canyon Rd, Santa Barbara, CA 93108-1633 | 2007-04-16 |
| 1588209357 | Cottage Clinical Network, LLC | General Practice | 400 W Pueblo St, Santa Barbara, CA 93105-4353 | 2019-11-15 |
| 1568824167 | Michael David Weed | General Practice | 400 W Pueblo St, Santa Barbara, CA 93105-4353 | 2016-03-22 |
| 1730419847 | Integrative Medicine Center of Santa Barbara Inc | General Practice | 533 E Micheltorena St, Suite 101, Santa Barbara, CA 93103-2200 | 2010-01-12 |
| 1841452950 | Erin Greenspun Moore | General Practice | 2320 Bath St, Suite 201, Santa Barbara, CA 93105-4339 | 2008-06-30 |
| 1215022272 | Joanne S Garofalo | General Practice | 122 S Patterson Ave, 101, Santa Barbara, CA 93111-2055 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1255939674 | Kiira Health Practice Ca PC | General Practice | 123 S Figueroa St Apt 1202, Los Angeles, CA 90012-5490 | 2020-10-16 |
| 1851999627 | Golden State Medical Center PC | General Practice | 2551 San Ramon Valley Blvd Ste 108, San Ramon, CA 94583-1661 | 2020-10-14 |
| 1598362709 | Afua Takyi | General Practice | 1555 River Park Dr Ste 211, Sacramento, CA 95815-4604 | 2020-10-01 |
| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1376156109 | Gtl Medical Group Inc | General Practice | 14555 Hamlin St Ste 107, Van Nuys, CA 91411-1617 | 2020-08-31 |
| 1922611896 | Daniel Lynn Johnson | General Practice | 74075 El Paseo Ste B2, Palm Desert, CA 92260-4118 | 2020-08-28 |
| 1235755299 | Hofmeister Medical, PC | General Practice | 31735 Riverside Dr Ste K, Lake Elsinore, CA 92530-7816 | 2020-06-24 |
| 1033733779 | South Bay Regenerative Medical Spa Inc | General Practice | 412 S Pacific Coast Hwy Ste 100, Redondo Beach, CA 90277-3712 | 2020-05-28 |
| 1568085041 | Integrated Advanced Medicine Inc | General Practice | 210 S Grand Ave Ste 408, Glendora, CA 91741-4282 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
| City | SANTA BARBARA |
| Zip Code | 93105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.