Provider Demographics
NPI:1053364471
Name:WROBLEWSKI, EDMUND M (MD)
Entity type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:M
Last Name:WROBLEWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 BATH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4351
Mailing Address - Country:US
Mailing Address - Phone:805-682-7707
Mailing Address - Fax:805-682-7710
Practice Address - Street 1:2400 BATH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4351
Practice Address - Country:US
Practice Address - Phone:805-682-7707
Practice Address - Fax:805-682-7710
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44723174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA92519Medicare UPIN