Provider Demographics
NPI:1023220548
Name:BARTELL, ERIC MARTIN (DO)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:MARTIN
Last Name:BARTELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 E CLARK AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5188
Mailing Address - Country:US
Mailing Address - Phone:805-934-4801
Mailing Address - Fax:805-934-4804
Practice Address - Street 1:1140 E CLARK AVE STE 160
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5188
Practice Address - Country:US
Practice Address - Phone:805-934-4801
Practice Address - Fax:805-934-4804
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD6741156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician