Healthcare Provider Details

I. General information

NPI: 1831527407
Provider Name (Legal Business Name): VIGNA & VIGNA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 02/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 CALLE ABIERTA
SANTA BARBARA CA
93111-1125
US

IV. Provider business mailing address

944 CALLE ABIERTA
SANTA BARBARA CA
93111-1125
US

V. Phone/Fax

Practice location:
  • Phone: 805-963-3757
  • Fax: 805-564-3332
Mailing address:
  • Phone: 805-963-3757
  • Fax: 805-564-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberC54741
License Number StateCA

VIII. Authorized Official

Name: GREG A VIGNA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 318-548-2649