Provider Demographics
NPI:1639352859
Name:BARTOK, BEATRIX (MD)
Entity Type:Individual
Prefix:
First Name:BEATRIX
Middle Name:
Last Name:BARTOK
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 1:4168 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2030
Mailing Address - Country:US
Mailing Address - Phone:619-543-6248
Mailing Address - Fax:619-543-3511
Practice Address - Street 1:4168 FRONT ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2030
Practice Address - Country:US
Practice Address - Phone:619-543-6248
Practice Address - Fax:619-543-3511
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6353626-1205174400000X
UT6353626-8905174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist