Provider Demographics
NPI:1619967809
Name:DIZINNO, LIBRO EUGENIO (MD)
Entity Type:Individual
Prefix:
First Name:LIBRO
Middle Name:EUGENIO
Last Name:DIZINNO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9834 GENESEE AVENUE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-450-1010
Mailing Address - Fax:858-450-9451
Practice Address - Street 1:9834 GENESEE AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1223
Practice Address - Country:US
Practice Address - Phone:858-450-1010
Practice Address - Fax:858-450-9451
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2010-09-02
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Provider Licenses
StateLicense IDTaxonomies
CAC30996207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology