Provider Demographics
NPI:1477552941
Name:BARRETTO, ROBERTO LIMGENCO (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:LIMGENCO
Last Name:BARRETTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 N HIGHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-6479
Mailing Address - Country:US
Mailing Address - Phone:714-633-4020
Mailing Address - Fax:714-633-4846
Practice Address - Street 1:1201 W LA VETA AVE
Practice Address - Street 2:STE. 311
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4203
Practice Address - Country:US
Practice Address - Phone:714-633-4020
Practice Address - Fax:714-633-4846
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81316207YP0228X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A813160Medicaid
WA81316AMedicare ID - Type Unspecified
CA00A813160Medicaid