Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A81316 | CA |
N | 207YP0228X | Pediatric Otolaryngology | A81316 | CA |
NPI | 1477552941 |
---|---|
Provider Name | Roberto Limgenco Barretto |
First Address | Orange, CA 92867-6479 |
Second Address | Orange, CA 92868-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A813160 | (05) | CA |
H15812 | (02) |