Provider Demographics
NPI:1457530883
Name:WILLIAM BARGAR MD
Entity Type:Organization
Organization Name:WILLIAM BARGAR MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-733-5066
Mailing Address - Street 1:1020 29TH ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5125
Mailing Address - Country:US
Mailing Address - Phone:916-733-5066
Mailing Address - Fax:916-733-8705
Practice Address - Street 1:1020 29TH ST
Practice Address - Street 2:SUITE 450
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5125
Practice Address - Country:US
Practice Address - Phone:916-733-5066
Practice Address - Fax:916-733-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACG1704OtherRAILROAD MEDICARE GROUP N
CAA45766Medicare UPIN
CAZZZ19580ZMedicare PIN