Healthcare Provider Details

I. General information

NPI: 1184925125
Provider Name (Legal Business Name): BARTLEY S ASNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 TECHNOLOGY DR
IRVINE CA
92618-2302
US

IV. Provider business mailing address

7 TECHNOLOGY DR
IRVINE CA
92618-2302
US

V. Phone/Fax

Practice location:
  • Phone: 949-923-3200
  • Fax: 949-923-3498
Mailing address:
  • Phone: 949-923-3200
  • Fax: 949-923-3498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG34545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: