Provider Demographics
NPI:1699177733
Name:TYRREL SIGNORINI, BURGUNDY ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:BURGUNDY
Middle Name:ROSE
Last Name:TYRREL SIGNORINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BURGUNDY
Other - Middle Name:ROSE
Other - Last Name:TYRREL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3010 BEARD RD
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3442
Mailing Address - Country:US
Mailing Address - Phone:707-255-8825
Mailing Address - Fax:707-252-9325
Practice Address - Street 1:400 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4353
Practice Address - Country:US
Practice Address - Phone:805-682-7111
Practice Address - Fax:805-569-8368
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA134784208M00000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program