Provider Demographics
NPI:1184620411
Name:BARTLEY, JAMES ALVIN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALVIN
Last Name:BARTLEY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3701 WILSHIRE BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2814
Mailing Address - Country:US
Mailing Address - Phone:323-361-3550
Mailing Address - Fax:323-361-8052
Practice Address - Street 1:4000 14TH ST
Practice Address - Street 2:SUITE # 310
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4083
Practice Address - Country:US
Practice Address - Phone:909-633-6578
Practice Address - Fax:909-533-2342
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31441208000000X, 207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG314410Medicaid
CAA01393Medicare UPIN