Provider Demographics
NPI:1972704385
Name:BARCZAK, JEFFREY THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:THOMAS
Last Name:BARCZAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16622 CATALONIA DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-8701
Mailing Address - Country:US
Mailing Address - Phone:949-572-8398
Mailing Address - Fax:
Practice Address - Street 1:16622 CATALONIA DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-8701
Practice Address - Country:US
Practice Address - Phone:949-572-8398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12066207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology