Provider Demographics
NPI:1073956579
Name:BAR ZIV, DANIT (MD)
Entity Type:Individual
Prefix:
First Name:DANIT
Middle Name:
Last Name:BAR ZIV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23501 CINEMA DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5428
Mailing Address - Country:US
Mailing Address - Phone:661-288-4800
Mailing Address - Fax:
Practice Address - Street 1:23501 CINEMA DR
Practice Address - Street 2:SUITE 200
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5428
Practice Address - Country:US
Practice Address - Phone:661-288-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CAA1316442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB262012Medicaid