Provider Demographics
NPI:1780664250
Name:LONGOBARDI, JAMES JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:LONGOBARDI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 4TH AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4426
Mailing Address - Country:US
Mailing Address - Phone:619-425-5500
Mailing Address - Fax:
Practice Address - Street 1:450 4TH AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4426
Practice Address - Country:US
Practice Address - Phone:619-425-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3675213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E36750Medicaid
CAP00320031OtherRAILROAD MEDICARE
CA000E36750Medicaid
CAP00320031OtherRAILROAD MEDICARE