Provider Demographics
NPI:1598805855
Name:SUGINO, LAURA B (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:B
Last Name:SUGINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5436 RINCON BEACH PARK DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-9749
Mailing Address - Country:US
Mailing Address - Phone:805-643-2407
Mailing Address - Fax:
Practice Address - Street 1:345 CAMINO DEL REMEDIO
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1332
Practice Address - Country:US
Practice Address - Phone:805-681-5490
Practice Address - Fax:805-681-5411
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG70360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF44863Medicare UPIN