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NPI Code Detail

MEDICARE: BARTLETT WHITE PHYSICIAN ASSISTANT

MEDICARE: BARTLETT WHITE PHYSICIAN ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA22024CA
2363A00000XPhysician AssistantPA1301NV

General Provider Information

NPI Number : 1811274780
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARTLETT WHITE PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : PO BOX 660
Second Line :
City : MAMMOTH LAKES
State : CA
Zip : 93546-0660
Country : US
Telephone Number : 760-924-4084
Fax Number : 760-924-7285
Provider Business Practice Location Address
First Line : 85 SIERRA PARK RD
Second Line :
City : MAMMOTH LAKES
State : CA
Zip : 93546-2073
Country : US
Telephone Number : 760-924-4084
Fax Number : 760-924-7285
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2011
Last Update Date : 12/04/2025

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