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NPI Code Detail

MEDICARE: TATUM VEDDER

MEDICARE: TATUM VEDDER
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
1133V00000XRegistered Dietitian86155108CA

General Provider Information

NPI Number : 1144985391
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATUM VEDDER
Provider Business Mailing Address
First Line : 1433 SAN MIGUEL AVE
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93109-2044
Country : US
Telephone Number : 805-618-8167
Fax Number :
Provider Business Practice Location Address
First Line : 400 MOBIL AVE STE D9
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-6376
Country : US
Telephone Number : 805-738-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2021
Last Update Date : 02/08/2023

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Directions to “ TATUM VEDDER ” Practice Location

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