Individual
DR. MARIO FERNANDO SAN BARTOLOME JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5405 GARDEN GROVE BLVD STE 102, WESTMINSTER, CA 92683-1887
(714) 598-3707
(714) 422-0260
Mailing address
5405 GARDEN GROVE BLVD STE 102, WESTMINSTER, CA 92683-1887
(714) 598-3707
(714) 422-0260
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A89818
CA
207QA0000X
Adolescent Medicine (Family Medicine) Physician
A89818
CA
207QA0505X
Adult Medicine Physician
A89818
CA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
A89818
CA
Other
Enumeration date
09/21/2006
Last updated
08/08/2019
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