Provider Demographics
NPI:1194911065
Name:SANTA CLARITA VALLEY EYE MEDICAL GROUP INC
Entity type:Organization
Organization Name:SANTA CLARITA VALLEY EYE MEDICAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-259-6022
Mailing Address - Street 1:23861 MCBEAN PKWY
Mailing Address - Street 2:E12
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2058
Mailing Address - Country:US
Mailing Address - Phone:661-259-6022
Mailing Address - Fax:661-259-9742
Practice Address - Street 1:23861 MCBEAN PKWY
Practice Address - Street 2:E12
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2058
Practice Address - Country:US
Practice Address - Phone:661-259-6022
Practice Address - Fax:661-259-9742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10818207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP8816OtherRAILROAD MEDICARE PIN
CA00G108180Medicaid
CACP8816OtherRAILROAD MEDICARE PIN
CAA90090Medicare UPIN
CAW11375Medicare PIN