Provider Demographics
NPI:1689878225
Name:VITTO, VINCENZO (NONE) (DO)
Entity Type:Individual
Prefix:
First Name:VINCENZO
Middle Name:(NONE)
Last Name:VITTO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 NORTHRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-1930
Mailing Address - Country:US
Mailing Address - Phone:516-996-3610
Mailing Address - Fax:
Practice Address - Street 1:306 NORTHRIDGE RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-1930
Practice Address - Country:US
Practice Address - Phone:516-996-3610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A108442081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A10844OtherSTATE OSTEOPATHIC MEDICAL LICENSE
CA20A10844OtherSTATE OSTEOPATHIC MEDICAL LICENSE
CACA023ZMedicare PIN