Provider Demographics
NPI:1346371119
Name:BARTE MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:BARTE MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OPHELIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-288-1358
Mailing Address - Street 1:PO BOX 220243
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91322-0243
Mailing Address - Country:US
Mailing Address - Phone:661-288-1358
Mailing Address - Fax:661-288-1472
Practice Address - Street 1:23928 LYONS AVE STE 204
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2455
Practice Address - Country:US
Practice Address - Phone:661-288-1358
Practice Address - Fax:661-288-1472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA431892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A431890Medicaid
CA00A431890Medicaid
CAW12116Medicare ID - Type Unspecified