Provider Demographics
NPI:1962502948
Name:BARSHACK, SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:BARSHACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:H.
Other - Middle Name:SCOTT
Other - Last Name:BARSHACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 FIFER AVE #200
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925
Mailing Address - Country:US
Mailing Address - Phone:415-927-6690
Mailing Address - Fax:415-927-6688
Practice Address - Street 1:2 FIFER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925
Practice Address - Country:US
Practice Address - Phone:415-927-6690
Practice Address - Fax:415-927-6688
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG611792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G611790Medicaid
CAE41852Medicare UPIN
CA00G611790Medicaid