Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | A100181 | CA |
NPI | 1891884359 |
---|---|
Provider Name | Dale Amanda Tylor |
First Address | Santa Barbara, CA 93101-2481 |
Second Address | Santa Barbara, CA 93101-2481 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 13/11/2019 |