Provider Demographics
NPI:1528087632
Name:ALBERTINI, JOHN JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:ALBERTINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2576 RENFREW STREET
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501
Mailing Address - Country:US
Mailing Address - Phone:707-445-3257
Mailing Address - Fax:707-445-1027
Practice Address - Street 1:2576 RENFREW STREET
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501
Practice Address - Country:US
Practice Address - Phone:707-445-3257
Practice Address - Fax:707-445-1027
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85282208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G99020Medicare UPIN
CA00G852820Medicare ID - Type Unspecified