Provider Demographics
NPI:1013009760
Name:GARTENBERG, JOANNE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:E
Last Name:GARTENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:285 N EL CAMINO REAL
Mailing Address - Street 2:SUITE 219
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5383
Mailing Address - Country:US
Mailing Address - Phone:760-753-7490
Mailing Address - Fax:760-753-0785
Practice Address - Street 1:285 N EL CAMINO REAL
Practice Address - Street 2:SUITE 219
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5383
Practice Address - Country:US
Practice Address - Phone:760-753-7490
Practice Address - Fax:760-753-0785
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG493972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG49397Medicare UPIN
CAG49397Medicare ID - Type Unspecified