Provider Demographics
NPI:1801958525
Name:UYESAKA, JON (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:UYESAKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5333 HOLLISTER AVE
Mailing Address - Street 2:STE 255
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2470
Mailing Address - Country:US
Mailing Address - Phone:805-681-7204
Mailing Address - Fax:805-681-7206
Practice Address - Street 1:5333 HOLLISTER AVE
Practice Address - Street 2:STE 255
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2470
Practice Address - Country:US
Practice Address - Phone:805-681-7204
Practice Address - Fax:805-681-7206
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2017-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA71032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A710320Medicaid
CA00A710320Medicaid
CAH31870Medicare UPIN