Provider Demographics
NPI:1154407237
Name:BILLECI, BARTON THOMAS (MD)
Entity type:Individual
Prefix:
First Name:BARTON
Middle Name:THOMAS
Last Name:BILLECI
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 1:4050 BARRANCA PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-7706
Mailing Address - Country:US
Mailing Address - Phone:949-653-1173
Mailing Address - Fax:949-653-1152
Practice Address - Street 1:4050 BARRANCA PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-7706
Practice Address - Country:US
Practice Address - Phone:949-653-1173
Practice Address - Fax:949-653-1152
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0768740207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine