Provider Demographics
NPI:1720152861
Name:PHILIP C BARTLETT MD INC
Entity Type:Organization
Organization Name:PHILIP C BARTLETT MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PC PARTLETT MD INC
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:CARLETON
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-757-4914
Mailing Address - Street 1:3838 CALIFORNIA ST
Mailing Address - Street 2:#505
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118
Mailing Address - Country:US
Mailing Address - Phone:415-751-4914
Mailing Address - Fax:415-751-1414
Practice Address - Street 1:3838 CALIFORNIA ST
Practice Address - Street 2:#505
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-751-4914
Practice Address - Fax:415-751-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30928207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A34409Medicare UPIN
C309281Medicare ID - Type Unspecified