Provider Demographics
NPI:1063580900
Name:QUIJANO, RALPH (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:QUIJANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 DE LA VINA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3873
Mailing Address - Country:US
Mailing Address - Phone:805-965-7400
Mailing Address - Fax:805-965-2251
Practice Address - Street 1:2305 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3873
Practice Address - Country:US
Practice Address - Phone:805-965-7400
Practice Address - Fax:805-965-2251
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42581207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G425810OtherMEDI-CAL NUMBER
CAA92348Medicare UPIN