Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G75698 | CA |
N | 207RA0201X | Internist - Allergy & Immunology | G75698 | CA |
NPI | 1083778864 |
---|---|
Provider Name | Vincent Tubiolo |
First Address | Santa Barbara, CA 93105-4384 |
Second Address | Santa Barbara, CA 93105-4384 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 07/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F64415 | (02) | CA |