Provider Demographics
NPI:1710968425
Name:BARTE, OPHELIA G (MD)
Entity Type:Individual
Prefix:DR
First Name:OPHELIA
Middle Name:G
Last Name:BARTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 220243
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91322-0243
Mailing Address - Country:US
Mailing Address - Phone:661-424-1774
Mailing Address - Fax:661-424-1711
Practice Address - Street 1:27141 HIDAWAY AVE
Practice Address - Street 2:#203
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-4131
Practice Address - Country:US
Practice Address - Phone:661-424-1774
Practice Address - Fax:661-424-1711
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA431892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A431890Medicaid
CAC04018Medicare UPIN
CAW12116Medicare ID - Type Unspecified