Provider Demographics
NPI:1114269164
Name:BARON, VIDA CHIBUZO
Entity Type:Individual
Prefix:DR
First Name:VIDA
Middle Name:CHIBUZO
Last Name:BARON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 DEL PARQUE UNIT D
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-5730
Mailing Address - Country:US
Mailing Address - Phone:805-560-9070
Mailing Address - Fax:805-564-2339
Practice Address - Street 1:655 DEL PARQUE UNIT D
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-5730
Practice Address - Country:US
Practice Address - Phone:805-560-9070
Practice Address - Fax:805-564-2339
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-17
Last Update Date:2013-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE26745207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology