Provider Demographics
NPI:1952445116
Name:DIMARTINO, ROBERT BARBERO (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BARBERO
Last Name:DIMARTINO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 TARA RD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3128
Mailing Address - Country:US
Mailing Address - Phone:925-254-7491
Mailing Address - Fax:
Practice Address - Street 1:958 MORAGA RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4525
Practice Address - Country:US
Practice Address - Phone:925-283-3821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7943 TLG152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10624Medicare UPIN