Provider Demographics
NPI:1407953227
Name:BARTZ, PAUL E (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:BARTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41555 CHERRY ST
Mailing Address - Street 2:SUITE L
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6402
Mailing Address - Country:US
Mailing Address - Phone:951-600-8024
Mailing Address - Fax:951-600-8024
Practice Address - Street 1:41555 CHERRY ST
Practice Address - Street 2:SUITE L
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6402
Practice Address - Country:US
Practice Address - Phone:951-600-8024
Practice Address - Fax:951-600-8024
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556475111N00000X
CA30097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAV02450Medicare UPIN