Provider Demographics
NPI:1053461681
Name:BARSTOW USD
Entity Type:Organization
Organization Name:BARSTOW USD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-255-6009
Mailing Address - Street 1:3333 CONCOURS
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4875
Mailing Address - Country:US
Mailing Address - Phone:909-944-7798
Mailing Address - Fax:909-481-7410
Practice Address - Street 1:551 S AVENUE H
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-2500
Practice Address - Country:US
Practice Address - Phone:760-255-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS3667611OtherMEDI-CAL