Provider Demographics
NPI:1548222961
Name:BARBA - SIMIC, CELINA (MD)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:BARBA - SIMIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CELINA
Other - Middle Name:M
Other - Last Name:BARBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:800-749-4560
Mailing Address - Fax:405-751-3183
Practice Address - Street 1:501 S BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4809
Practice Address - Country:US
Practice Address - Phone:818-843-5111
Practice Address - Fax:405-751-3183
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA681360207P00000X, 207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00145680OtherRAILROAD MEDICARE
00A681360OtherBLUE SHIELD
CA00A681360Medicaid
A68136OtherBLUE CROSS
P00145680OtherRAILROAD MEDICARE
WA68136BMedicare ID - Type Unspecified