Healthcare Provider Details

I. General information

NPI: 1164471215
Provider Name (Legal Business Name): BARSTOW SURGICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E. VIRGINIA WAY SUITE B
BARSTOW CA
92311-3955
US

IV. Provider business mailing address

705 E. VIRGINIA WAY STE B
BARSTOW CA
92311-3955
US

V. Phone/Fax

Practice location:
  • Phone: 760-256-4651
  • Fax: 760-255-2280
Mailing address:
  • Phone: 760-256-4651
  • Fax: 760-255-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA32782
License Number StateCA

VIII. Authorized Official

Name: DR. ARTRURO TALON SANTOS
Title or Position: PRESIDENT
Credential: MD
Phone: 760-256-4651