MEDICARE: DR. JAY P DILIBERTO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	G65221	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821154105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY P DILIBERTO MD

Provider Business Mailing Address
First Line	:	18800 DELAWARE ST STE 850
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6087
Country	:	US
Telephone Number	:	714-596-2800
Fax Number	:	714-596-0551

Provider Business Practice Location Address
First Line	:	18800 DELAWARE ST STE 850
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6087
Country	:	US
Telephone Number	:	714-596-2800
Fax Number	:	714-596-0551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	07/08/2007

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