Provider Demographics
NPI:1407959067
Name:DIBARTOLOMEO, JOSEPH R (MD, INC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:DIBARTOLOMEO
Suffix:
Gender:M
Credentials:MD, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 CASTILLO ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4346
Mailing Address - Country:US
Mailing Address - Phone:805-563-1111
Mailing Address - Fax:805-563-2277
Practice Address - Street 1:2420 CASTILLO ST STE 100
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4346
Practice Address - Country:US
Practice Address - Phone:805-563-1111
Practice Address - Fax:805-563-2277
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG145220207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WG14522AOtherPERFORMING DR
W1373Medicare ID - Type Unspecified