Provider Demographics
NPI:1649378084
Name:BALBIR S. BRAR, M.D., INC.
Entity type:Organization
Organization Name:BALBIR S. BRAR, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BALBIR
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-253-3008
Mailing Address - Street 1:P.O.BOX 55283
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91385-0283
Mailing Address - Country:US
Mailing Address - Phone:661-253-3008
Mailing Address - Fax:661-253-1448
Practice Address - Street 1:23861 MCBEAN PKWY
Practice Address - Street 2:SUITE D16
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355
Practice Address - Country:US
Practice Address - Phone:661-253-3008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOA43171OMedicaid
CAW20603Medicare PIN
CAOOA43171OMedicaid