Provider Demographics
NPI:1891884359
Name:TYLOR, DALE AMANDA (MD)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:AMANDA
Last Name:TYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 STATE ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2481
Mailing Address - Country:US
Mailing Address - Phone:805-327-6673
Mailing Address - Fax:805-946-1368
Practice Address - Street 1:1819 STATE ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2481
Practice Address - Country:US
Practice Address - Phone:805-327-6673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100181207YP0228X, 207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology