Provider Demographics
NPI:1053751388
Name:TERRENCE EARLY MD INC
Entity type:Organization
Organization Name:TERRENCE EARLY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFFARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-845-8770
Mailing Address - Street 1:111 W MICHELTORENA ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3095
Mailing Address - Country:US
Mailing Address - Phone:805-845-8770
Mailing Address - Fax:805-845-0997
Practice Address - Street 1:111 W MICHELTORENA ST
Practice Address - Street 2:SUITE 320
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3095
Practice Address - Country:US
Practice Address - Phone:805-845-8770
Practice Address - Fax:805-845-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG881652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACU738AMedicare UPIN