MEDICARE: DR. VIDA CHIBUZO BARON

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	207L00000X	Anesthesiology Physician	GFE26745	CA

General Provider Information

NPI Number	:	1114269164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIDA CHIBUZO BARON

Provider Business Mailing Address
First Line	:	655 DEL PARQUE UNIT D
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-5730
Country	:	US
Telephone Number	:	805-560-9070
Fax Number	:	805-564-2339

Provider Business Practice Location Address
First Line	:	655 DEL PARQUE UNIT D
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-5730
Country	:	US
Telephone Number	:	805-560-9070
Fax Number	:	805-564-2339

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

Provider Enumeration Date	:	03/17/2013
Last Update Date	:	03/17/2013

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