Healthcare Provider Details

I. General information

NPI: 1174523831
Provider Name (Legal Business Name): BARLOW PULMONARY MED GRP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 STADIUM WAY
LOS ANGELES CA
90026-2606
US

IV. Provider business mailing address

2000 STADIUM WAY
LOS ANGELES CA
90026-2606
US

V. Phone/Fax

Practice location:
  • Phone: 213-250-4200
  • Fax: 213-250-3274
Mailing address:
  • Phone: 213-250-4200
  • Fax: 213-250-3274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License NumberW10197/GR0026170
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberW10197/GR0026170
License Number StateCA

VIII. Authorized Official

Name: MRS. VICTORIA S MELCHOR
Title or Position: OFFICE MANAGER
Credential:
Phone: 213-250-4200