Healthcare Provider Details

I. General information

NPI: 1801985569
Provider Name (Legal Business Name): RENATO B. BARGA, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23845 MCBEAN PKWY
VALENCIA CA
91355-2001
US

IV. Provider business mailing address

101 S 1ST ST 1000
BURBANK CA
91502-1938
US

V. Phone/Fax

Practice location:
  • Phone: 661-253-8000
  • Fax: 661-253-8142
Mailing address:
  • Phone: 818-845-6206
  • Fax: 818-845-9774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA40782
License Number StateCA

VIII. Authorized Official

Name: RENATO B. BARGA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 661-288-5827