Healthcare Provider Details

I. General information

NPI: 1518820018
Provider Name (Legal Business Name): CHERYL BARTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15191 CAYUSE CT
RIVERSIDE CA
92506-5764
US

IV. Provider business mailing address

15191 CAYUSE CT
RIVERSIDE CA
92506-5764
US

V. Phone/Fax

Practice location:
  • Phone: 818-981-5061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number792554
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: