MEDICARE: ELIZABETH BABU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	A117761	CA

General Provider Information

NPI Number	:	1073796009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BABU MD

Provider Business Mailing Address
First Line	:	1910 OUTLET CENTER DR
Second Line	:	#159
City	:	OXNARD
State	:	CA
Zip	:	93036-0677
Country	:	US
Telephone Number	:	805-485-2400
Fax Number	:	805-485-3025

Provider Business Practice Location Address
First Line	:	567 W CHANNEL ISLANDS BLVD
Second Line	:	#159
City	:	PORT HUENEME
State	:	CA
Zip	:	93041-2133
Country	:	US
Telephone Number	:	516-303-6931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	08/09/2016

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