Healthcare Provider Details

I. General information

NPI: 1609841899
Provider Name (Legal Business Name): ROBERTA BRUNI BARNETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBERTA BRUNI MD

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 03/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9920 TALBERT AVE
FOUNTAIN VALLEY CA
92708-5153
US

IV. Provider business mailing address

770 THE CITY DR S STE 4000
ORANGE CA
92868-4929
US

V. Phone/Fax

Practice location:
  • Phone: 714-378-7000
  • Fax: 714-620-3010
Mailing address:
  • Phone: 800-463-6628
  • Fax: 714-620-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA51854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: