Provider Demographics
NPI:1366444838
Name:BARAG, STEVEN HARRY (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:HARRY
Last Name:BARAG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7974 HAVEN AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3052
Mailing Address - Country:US
Mailing Address - Phone:909-355-1601
Mailing Address - Fax:909-987-0011
Practice Address - Street 1:7974 HAVEN AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3052
Practice Address - Country:US
Practice Address - Phone:909-355-1601
Practice Address - Fax:909-987-0011
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A3825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33-0881908OtherTAX ID
CA020A38251Medicaid
CA20A3825OtherLICENSE
CA602070100OtherDOL
CA602070100OtherDOL
CA602070100OtherDOL
CA020A38251Medicaid