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JACKSON & ENGBERG MEDICAL CORPORATION NPI 1891711289


NPI Information

NPI: 1891711289
Provider Name: JACKSON & ENGBERG MEDICAL CORPORATION

Doing Business As: JACKSON MEDICAL GROUP INC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D1006663

Address:
517 W JUNIPERO ST
SANTA BARBARA, CA
ZIP 93105
Phone: (805) 682-8844
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JACKSON & ENGBERG MEDICAL CORPORATION is a family medicine in Santa Barbara, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JACKSON & ENGBERG MEDICAL CORPORATION NPI is 1891711289. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Jackson Medical Group Inc.

The provider's business location address is:

517 W JUNIPERO ST
SANTA BARBARA, CA
ZIP 93105-239
Phone: (805) 682-8844
Fax: (805) 682-4735

The provider's authorized official is Karen M Engberg .
The authorized official title is President and has the following contact phone number (805) 682-8844.

The CLIA number assigned to this NPI record is 05D1006663 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/15/2006 and was last updated on 1/17/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W15885MEDICARE PINCALIFORNIA
21891711289OTHERCALIFORNIANPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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