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NPI Code Detail

MEDICARE: DR. TIFFANY CORBY O.D.

MEDICARE: DR. TIFFANY CORBY O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152WP0200XPediatric Optometrist11870TCA
2152WV0400XVision Therapy Optometrist11870TCA
3152WC0802XCorneal and Contact Management Optometrist11870TCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
177-0049461OTHEROLD TAX ID#
259-3792228OTHERCURRENT TAX ID#
311870TOTHERCAOPT. LISC #

General Provider Information

NPI Number : 1164455812
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY CORBY O.D.
Provider Business Mailing Address
First Line : 5300 HOLLISTER AVE
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93111-2306
Country : US
Telephone Number : 805-692-6977
Fax Number : 805-692-6987
Provider Business Practice Location Address
First Line : 5300 HOLLISTER AVE
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93111-2306
Country : US
Telephone Number : 805-692-6977
Fax Number : 805-692-6987
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2006
Last Update Date : 03/07/2023

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