Provider Demographics
NPI:1659578698
Name:BARBARINO, SHEILA CHANG (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:CHANG
Last Name:BARBARINO
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 1:1916 CUEVA DE ORO CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7722
Mailing Address - Country:US
Mailing Address - Phone:215-518-3385
Mailing Address - Fax:
Practice Address - Street 1:2284 E MAPLE AVE
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-6507
Practice Address - Country:US
Practice Address - Phone:310-402-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107345207W00000X
NY237684207W00000X
TXQ1948207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13961COtherMEDICARE GROUP PTAN
CAA107345OtherMEDICAL LICENSE
CAW13961OtherMEDICARE GROUP PTAN
CAW13961AOtherMEDICARE GROUP PTAN
CAW13961BOtherMEDICARE GROUP PTAN
CAW13961OtherMEDICARE GROUP PTAN
CAW13961AOtherMEDICARE GROUP PTAN
CABU440YMedicare PIN
CAA107345OtherMEDICAL LICENSE