MEDICARE: JULIO GABRIEL DIAZ 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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	A36932	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801880638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIO GABRIEL DIAZ MD

Provider Business Mailing Address
First Line	:	510 N MILPAS ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-3137
Country	:	US
Telephone Number	:	805-962-8880
Fax Number	:	805-957-1642

Provider Business Practice Location Address
First Line	:	510 N MILPAS ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-3137
Country	:	US
Telephone Number	:	805-962-8880
Fax Number	:	805-957-1642

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	07/08/2007

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