Healthcare Provider Details

I. General information

NPI: 1851537435
Provider Name (Legal Business Name): JULIO DIAZ MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2009
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 N MILPAS ST
SANTA BARBARA CA
93103-3137
US

IV. Provider business mailing address

510 N MILPAS ST
SANTA BARBARA CA
93103-3137
US

V. Phone/Fax

Practice location:
  • Phone: 805-962-8880
  • Fax: 805-957-1642
Mailing address:
  • Phone: 805-962-8880
  • Fax: 805-957-1642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA36932
License Number StateCA

VIII. Authorized Official

Name: JULIO GABRIEL DIAZ
Title or Position: PRESIDENT
Credential: MD
Phone: 805-962-8880