Provider Demographics
NPI:1912921875
Name:BATTEN, DON GARY (DO)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:GARY
Last Name:BATTEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:D. GARY
Other - Middle Name:
Other - Last Name:BATTEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 537
Mailing Address - Street 2:
Mailing Address - City:BLUE JAY
Mailing Address - State:CA
Mailing Address - Zip Code:92317-0537
Mailing Address - Country:US
Mailing Address - Phone:909-336-6919
Mailing Address - Fax:
Practice Address - Street 1:257 NORTH FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352
Practice Address - Country:US
Practice Address - Phone:909-336-6919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine