Provider Demographics
NPI:1437250354
Name:LIBRETTO, JOSEPH E
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:LIBRETTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 SMITH LN # A
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-2538
Mailing Address - Country:US
Mailing Address - Phone:949-361-1429
Mailing Address - Fax:
Practice Address - Street 1:5TH MARINE REGIMENT, FIRST MARINE DIVISION
Practice Address - Street 2:62 ABMC/BULIDING 620305 8TH STREET CAMP SAN MATEO
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman