MEDICARE: DR. CHRISTOPHER BERNAL QUIJANO DO

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	208600000X	Surgery Physician	17289	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17289	OTHER	CA	MEDICAL BOARD OF CALIFORNIA

General Provider Information

NPI Number	:	1912314295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER BERNAL QUIJANO DO

Provider Business Mailing Address
First Line	:	520 W JUNIPERO ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-4212
Country	:	US
Telephone Number	:	805-730-1470
Fax Number	:	805-430-1473

Provider Business Practice Location Address
First Line	:	520 W JUNIPERO ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-4212
Country	:	US
Telephone Number	:	805-730-1470
Fax Number	:	805-430-1473

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

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	07/23/2019

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