Antoinette Carmen San Bartolome, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A87054 Issued in CA

Practice address

901 Oak Park Boulevard
Suite 101
Pismo Beach, CA 93449-3409

Phone

(805) 489-2205

Fax

(805) 489-2206

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• First Choice Physician Partners

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1912264862

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1912128802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1410",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934481410",
            "telephone_number": "805-489-2205",
            "fax_number": "805-489-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BOULEVARD",
            "address_2": "SUITE 101",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493409",
            "telephone_number": "805-489-2205",
            "fax_number": "805-489-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN BARTOLOME",
        "first_name": "ANTOINETTE",
        "middle_name": "CARMEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A87054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A87054",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Richard Sabo, MD
• K. George Sachariah, MD
• Sacred Path
• Randall H. Safarik, M.D.
• Rebecca Samet, M.D
• San Luis Physical Therapy & Orthopedic Rehabilitation Inc
• Dewey Sandberg, MD
• Lisa Ruth Saslove, MSRD
• Scott Eric Schachter, O.D.
• Briana Leigh Schiro

• Family Medicine Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.