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General NPI Number Information
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NPI Number | 1184638223
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Entity Type | Individual
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Provider Name | THERESA AQUINO BARTOLOME MD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 2176 SALK AVE
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City | CARLSBAD
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State | CA
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Zip | 92008-7346
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Country | US
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Telephone | 760-827-7200
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Fax | 760-827-7225
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Provider Business Mailing Address
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Address Line | 2201 MISSION AVE
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City | OCEANSIDE
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State | CA
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Zip | 92054-2328
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Country | US
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Telephone | 760-827-7200
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Fax | 760-827-7225
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A81251
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License Number State | CA
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