Healthcare Provider Details

I. General information

NPI: 1174765952
Provider Name (Legal Business Name): THEODORE N ARMSTRONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 E CLARK AVE STE 120A
SANTA MARIA CA
93455-5175
US

IV. Provider business mailing address

200 W ARBOR DR DEPARTMENT OF EMERGENCY MEDICINE--MC8819
SAN DIEGO CA
92103-9000
US

V. Phone/Fax

Practice location:
  • Phone: 805-332-8185
  • Fax:
Mailing address:
  • Phone: 619-543-6463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA113222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: