Provider Demographics
NPI:1124125208
Name:BARGER, MICHAEL THOMAS (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:THOMAS
Last Name:BARGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 Q ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7058
Practice Address - Country:US
Practice Address - Phone:916-733-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71768207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1089860OtherGREAT WEST
CA4507068OtherAETNA
CAMCMG167400OtherWESTERN HEALTH ADVANTAGE
CA2258910OtherFIRST HEALTH
CAG71768OtherBLUE CROSS
CA3389764OtherCIGNA
CA00G717680Medicaid
CA1051751OtherFIRST HEALTH
CA000810342515OtherPHCS
CA00G717680OtherBLUE SHIELD
CA1452786OtherUNITED
CA500837OtherHEALTH NET
CA2367OtherINTERPLAN
CA90026133OtherPACIFICARE
CA500837OtherHEALTH NET
E51273Medicare UPIN