Provider Demographics
NPI:1770979361
Name:URBANO, BILLY (MD)
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:URBANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 LIBERTY CT
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-4738
Mailing Address - Country:US
Mailing Address - Phone:209-914-2419
Mailing Address - Fax:
Practice Address - Street 1:830 LIBERTY CT
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-4738
Practice Address - Country:US
Practice Address - Phone:209-914-2419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant