Healthcare Provider Details

I. General information

NPI: 1972600260
Provider Name (Legal Business Name): ELISABETH MITCHELL BARBOSA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELISABETH HEWITT MITCHELL M.D.

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2361 E VINEYARD AVE
OXNARD CA
93036-2102
US

IV. Provider business mailing address

2361 E VINEYARD AVE
OXNARD CA
93036-2102
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-3770
  • Fax:
Mailing address:
  • Phone: 805-981-3770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0101238847
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberAFE94789
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: