Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-519 | CA |
NPI | 1073870549 |
---|---|
Provider Name | Dr. Tom Douglas Matteucci |
First Address | Santa Barbara, CA 93101-2115 |
Second Address | Santa Barbara, CA 93101-2115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2012 |
Last Update Date | 26/08/2016 |