Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DJ21411 | CA |
NPI | 1013049121 |
---|---|
Provider Name | James A Tamborello |
First Address | Santa Barbara, CA 93101 |
Second Address | Santa Barbara, CA 93101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2007 |