Provider Demographics
NPI:1548526619
Name:VIGLIONE, ALAN JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JUSTIN
Last Name:VIGLIONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1127 COAST VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTECITO
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2716
Mailing Address - Country:US
Mailing Address - Phone:805-892-6500
Mailing Address - Fax:805-209-0972
Practice Address - Street 1:1127 COAST VILLAGE RD
Practice Address - Street 2:
Practice Address - City:MONTECITO
Practice Address - State:CA
Practice Address - Zip Code:93108-2716
Practice Address - Country:US
Practice Address - Phone:805-892-6500
Practice Address - Fax:805-209-0972
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA129578207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program