Basic Information
| Provider Information | |||||||||
| NPI: | 1285868539 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FITZGIBBONS | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | NISBET | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | NISBET | ||||||||
| OtherFirstName: | LYNN | ||||||||
| OtherMiddleName: | MERI | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 50706 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931500706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059633757 | ||||||||
| FaxNumber: | 8055643332 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 W PUEBLO ST RM 3635 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055697315 | ||||||||
| FaxNumber: | 8055698358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2009 | ||||||||
| LastUpdateDate: | 08/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A99152 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | MD150725 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.