Healthcare Provider Details

I. General information

NPI: 1265920045
Provider Name (Legal Business Name): VINCENT TUBIOLO MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 BATH ST STE 303
SANTA BARBARA CA
93105-4384
US

IV. Provider business mailing address

2320 BATH ST STE 303
SANTA BARBARA CA
93105-4384
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-7385
  • Fax: 805-569-3891
Mailing address:
  • Phone: 805-682-7385
  • Fax: 805-569-3891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberG075698
License Number StateCA

VIII. Authorized Official

Name: VINCENT C TUBIOLO
Title or Position: OWNER
Credential: MD
Phone: 805-682-7385