Provider Demographics
NPI:1063551760
Name:NEIL M. BARTH, M.D., INC.
Entity type:Organization
Organization Name:NEIL M. BARTH, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-553-3330
Mailing Address - Street 1:20162 SW BIRCH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0787
Mailing Address - Country:US
Mailing Address - Phone:949-553-3330
Mailing Address - Fax:949-631-9012
Practice Address - Street 1:20162 SW BIRCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0787
Practice Address - Country:US
Practice Address - Phone:949-553-3330
Practice Address - Fax:949-631-9012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37824207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA04021700001OtherDMERC
CAGR0041390Medicaid
CAG37824OtherBLUE CROSS OF CALIFORNIA
CAWG37824COtherMEDICARE PPIN
CAZZZ053082OtherBLUESHIELD
CAGR0041390Medicaid
CAWG37824COtherMEDICARE PPIN