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Individual
JOSEPH D BETTENCOURT
Active
Individual
JOSEPH D BETTENCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A067264
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A672640
BLUE SHIELD PROVIDER #
CA
01
—
7920125
AETNA PIN
CA
Enumeration date
05/15/2006
Last updated
09/19/2023
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