Healthcare Provider Details

I. General information

NPI: 1558638858
Provider Name (Legal Business Name): BARTON SPARAGON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 OAK PARK DR
SAN FRANCISCO CA
94131-1027
US

IV. Provider business mailing address

437 OAK PARK DR
SAN FRANCISCO CA
94131-1027
US

V. Phone/Fax

Practice location:
  • Phone: 415-516-2252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberG60031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: