Provider Demographics
NPI:1710228598
Name:PATTILLO, CAROL ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ELLEN
Last Name:PATTILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:157 SANTA ELENA LN
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2512
Mailing Address - Country:US
Mailing Address - Phone:805-969-1558
Mailing Address - Fax:805-969-1558
Practice Address - Street 1:157 SANTA ELENA LN
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-2512
Practice Address - Country:US
Practice Address - Phone:805-969-1558
Practice Address - Fax:805-969-1558
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAGFE240232085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology